I've gotten past most of my problems by using a custom .asoundrc, tweaking settings here and there, and have fixed the stuttering by using a low-latency kernel, BUT...
One last major problem is my inability to "ring" anything but my USB phone handset. Is the only way to get ringing by setting "calls" to /dev/dsp?
That sucks bigtime.
None of the notification options seem to be all that useful. Ring PC speaker for me just provides one tone.