Everyone watches the ball handler come off the pick, which is exactly why the other four defenders keep getting beaten.
The screener is the one being guarded badly
Freeze a pick and roll at the moment of contact and look away from the ball. Look at the man setting the screen, and look at who is responsible for him. Nine times out of ten that defender is doing something faintly apologetic, standing at an angle that commits to nothing, waiting to find out what the guard does before he decides what he is.
That hesitation is where possessions are lost, and it almost never gets named as the error. The guard turns the corner, somebody rotates late, a shooter is open in the corner, and the review blames the rotation. The rotation was late because the big made his decision late. He made it late because nobody had told him what the decision was.
Part of this is a coaching habit. We describe coverages from the ball handler outwards. Drop, hedge, blitz, ice, all of it named for what happens to the guard. The screener defender is described by what he is not doing, which is a strange way to brief the man who has to move first.
The better teams invert it. They tell the big what he is, in advance, per opponent, and they let the guard adapt to him rather than the other way round. It sounds like a small reordering and it changes the timing of the whole possession, because the first movement is now a decision made before the screen instead of a reaction taken after it.
There is also an honesty problem in how we measure this. A big who plays a disciplined drop and gives up a contested pull-up has done his job. It goes down as a made shot against him. A big who lunges out, gets beaten, and forces a scrambling rotation that eventually produces a turnover looks aggressive and gets credit. One of those two is playing good defence and it is not the one who ends up on the highlight.
Ask a coach who his best pick and roll defender is and he will name a guard. Ask him who loses him possessions and he will describe, without quite realising it, a big man who was never told what to be.

