Truth is, nowadays if you run into a medic + anything else, you're dead before the medic unless you use the backburner. Every once in a while you get lucky with a rocket reflection, but soldiers ain't stupid, so now they use shotguns against pyros. If you're up against a demo, they either have a shield that prevents some of your damage, or a sticky launcher that you can't do much about.
Scouts can run backwards and still evade you, and snipers have piss to extinguish you. Spy checking works, but as it was said, a burning spy can plug your skull with the ambassador if you don't kill them fast enough. Against pyros, you have what I call the pyro salute: you both bounce back and then move on to better targets or use the shotgun like a scout wannabe.
Yes, you can still kill as a pyro, but you have to be much much more opportunistic, and to me that isn't skill, that's just a player hanging back only to get the scraps. Or you can become a spy prevention tool around a turret, the homewrecker kinda gives you that role now.
So other than developing a skill to aim for the downed target I don't see much happening to the pyro other than a buff to either the damage, the functionality of the weapon, or even just speed, without breaking the class. It's already quite fragile at this point.