Also, there are other ways to do calls to action besides placement. Such things like color, contrast, proximity, size, etc. etc. Most of these things are generally considered styling.

I agree with Alec in that a good designer with their salt should know how to do placement (and styling!) properly. It’s part of the wireframing process. I don’t think it’s realistic to expect a client to know how to do that before hiring a designer.

Real designers are, or at least try to be, experts in interfaces. Design is not styling. It can include styling, but it’s much more broad. A designer worth their pay will know where things should go, or know how to figure it out.

Semantics:
“But design doesn’t matter. What matters is the placement of elements and how well they work toward your goal. Element placement is design but not in the way that most people think of it – it’s not what a page looks like.”

Design does matter, it’s the style that doesn’t. The second sentence there practically is a definition of design. The third sentence is why I’m so picky about terminology and sentences like the first.