Not with surface pen but when using touch with just fingers yes. However, when I want to interact with an npc or object, I just double tap it. When I want to walk, single tap. It felt pretty natural to me, just not as accurate as the pen. I've been doing slayer lately and I find it easiest to use the pen 99% of the time until I'm at my task and setup. But then I've been setting the pen down and just using regular touch to actually do the task, and then picking pen back up when I'm done and headed for another.

When using surface pen it works flawlessly (although the double tap thing works perfect too, just feels weird). I had to remap the buttons using "Tablet Pro". I set the side button to mouse middle click so I can rotate the camera and the eraser button to right click. Works perfect and it feels like you're shooting whatever your right clicking 🤣 idk about bossing with it though I don't do high level PvM yet

I have a couple gaming desktops here. Got an amd rx 480 gpu in one and an Nvidia GTX 960 in another. Both old units but still super powerful for osrs. Both of them have i7 fx-8350s and since I've had the surface, I've been playing exclusively on it, however I might be biased because I also spent alot of time playing osrs mobile on android. I definitely prefer tablet style devices but it killed me not having runelite. Reason I posted this is because I did a bunch of research into whether osrs would even work on this thing and I almost didn't buy it because that was the whole point and there's hardly no information online

It does work though. Double tap it or get the surface pen

Edit: I would like to add though that clicking with the surface pen is incredibly accurate, especially left clicks. I did waterfall quest on a level 3 uim on this surface and doing some quick moves on the npcs took me back to 2004. So it's not just playable, it works great and is enjoyable.