Earlier quoted context omitted.
Mark Ferrari also teamed up with Ron Gilbert and Gary Winnick (et al) to create a new 2D adventure game called Thimbleweed Park[1] (No affiliation!) - awesome backgrounds by Ferrari! https://blog.thimbleweedpark.com/
In this talk he goes into detail about the Thimbleweed Park art he made and how he uses Photoshop to pull off pixel art techniques far more efficiently.
Palatte shifting and limited color palates were born from the necessity of effeciency. Now he has to use an emulated DOS program to edit them. He uses an experimental web app to display palate shifting projects he created years ago and looks forward to the upcomming release of a pixel editor from the same author.
Additionally, he expresses extensive configuration necessary, mostly disabling anti-aliasing within multiple tools, which makes his process possible in Photoshop. He also has removed the limitation of color palate to make the final product more pleasing, regardless of weight and efficiency, as the concern is minimal on modern hardware.
His technique in Photoshop makes heavy use of the pencil tool one pixel at a time and even falls back to antiquated software (or manual technique) when he needs to implement dithered gradients.
I did not get the inpression that he was happy to be using Photoshop, but that it is currently the best option he has.