First of all, it is completely meaningless to talk about shooting to point of aim unless you accompany the statement with how far away the target is. Most revolvers are set up so the bullet rises for a while after it leaves the muzzle. At some point it noses over and starts heading down towards the ground. Ideally, a gun shoots to point of aim at some specific range. It is impossible for it to shoot to point of aim at all distances. You guys who talk about how your guns shoot to point of aim need to qualify that statement with how far away the target is.
Secondly, you can vary the point of impact by varying the load. Very generally speaking, the more recoil, the higher the gun prints.
I grew up with Blackhawks and Smiths with adjustable sights. Like most adjustable sight shooters, I was worried when I bought my first non-adjustable sighted revolver, a S&W Model 10 if I recall correctly. At this point I own far more fixed sight revolvers than adjustable sighted ones. Smiths, Colts, Rugers, you name it. I don't worry anymore about I just shoot them all and have a ball with them. Some shoot to point of aim, some don't. One of my Colts shoots dead center, the other shoots a little bit to the left. It ain't me, that is the way both guns shoot.
There are several things you can do even to a fixed sight revolver if you really want to alter where it prints. Once you have settled on a load, if the gun is printing high, you carefully file down the front sight until it prints where you want it. For windage one can open up the rear sight slightly on one side or the other, or the old solution with single action revolvers is to turn the barrel sliightly.
My first Vaquero I carefully filed down the front sight until I got it shooting right where I wanted it at Cowboy Action Shooting ranges. That's the last time I bothered. Now I just hold to the right a little bit if I need to.
Adjustable sights are highly over rated.