Hopefully followers are more useful in 4. In 2 if you had a follower who had a repair skill you could tell him to fix stuff for you or if you had a doctor he could heal you. Hopefully you can do the same with FO4 followers.
However the absence of skills concerns me. Skills for combat purposes were kind of redundant since the game is a shooter, however all the noncombat aspects actually need to be skills. First aid determined how well you could heal someone, doctor determined how well you could fix bones and healing crippled parts, repair determined how well you could fix things like power generators and what not, barter allowed you to get better prices for buying and selling, etc. So are skills going to be merged with perks where you just rank them up 1, 2, 3? Or are they going to go the mini-game route where you want to heal someone up, the game turns into surgeon simulator? Or if you want to repair something you have to manually fit the piece in your self and wrench it, or if you want to speech/barter someone you have to guess the right sentence to say kind of like the Deus Ex and how the Hacking and locking picking mini-games work? Many questions on how that will work.