Does it concern anyone that, in order to replace a burned out fuse in this panel, you have to open some type of main disconnect (also a fairly frightening-looking device, I'm sure) ahead of this panel and kill all these circuits?

Only a person intent on committing suicide would try to replace a fuse while this panel is energized.

AGREED! If this panel runs hot enough that the door has to be left open, there are serious problems here. Many years ago, I saw a large fuse panel in a theater projection room where the entire panel front was removed due to the intense heat inside - you could literally feel the heat radiating from the panel as you passed in front of it. A middle-of-the-night electrical fire was the eventual outcome.

Mike (mamills)