What was the printer? It certainly wasn't producing letter-quality output.
Additionally nearly all of the other dot matrix printing was done based on low quality build in fonts. Send some text to output with control codes and you got output. The Mac basically painted pixel on the printer, so what ever font or image you had on the screen was accurately rendered.
Prior to the Mac/ImageWriter combination most of the letter quality (meaning good enough for business correspondence) printing I had seen was done via typewriters wired up to computers. Afterward, many businesses decided the Mac/ImageWriter was good enough for many purposes.
Edit: oh, I forgot there were also Daisy Wheel printers https://en.wikipedia.org/wiki/Daisy_wheel_printer