The push to make clinical trials more patient-centric from regulatory bodies and innovative organizations has led to many claims: "Listen to patients," "leverage decentralization," "engage more ethnically diverse Principal Investigators to access ethnically diverse participants." Each of these claims have merit, yet for all the patient panels convened, patient-centric consultants hired, and internal initiatives launched, data has yet to fully realize meaningful shifts in the accessibility of clinical trials to most folks. I’d like to suggest that is because even the most valuable initiatives, while necessary, are rarely sufficient to create patient-centric clinical trials.