Seems to me that a lot of the reason people are nervous about high density altitudes isn't so much the reduced performance and higher groundspeeds required to get airborne, although these definitely factor in.
The biggest reason appears to me to be the fact that nobody knows just how much runway it's going to take. "Performance charts are based on a new airplane, test pilot, yada yada yada."
Two things, IMO, would solve a lot of that particular problem. First, calculate takeoff and landing distances, and compare them to your actual distances on a regular basis.
When we were early in my PPL, (April in MD) my instructor had me note the time and distance it took to reach rotation speed. Later on (August), he had me do it again - same runway, close as far as wind went, density altitude 3000+ feet higher. I saw the difference in runway required. It always stuck with me. A flight early in the morning and mid afternoon could have similar effect.
Second,...
...making your 70/50* check ...
*70% of liftoff speed by 50% of runway.
For my Maule (which has no performance charts), I've determined appropriate numbers to use with my T.O.P. Computer, and the resulting calculations are very accurate. I've gone so far as to compute a nearly-MGW takeoff on an 80-degree day from my 1500-ft strip (uphill 2% average) as requiring 1300 feet, and making the takeoff. Granted, I had nice rollout/clearway off the end, but my halfway marker told me I was on target, and I lifted off about 200 ft from the end.
While I'm not advocating planning on lifting off with minimal runway to spare without some solid alternatives, I don't think this type of accuracy is beyond the capabilities of the vast majority of pilots. They just have to learn to do it. Then, when you get to high density altitudes, you have confidence in your knowledge of what is actually required.
Fly safe!
David