In this “Wait, But Why?” episode, we dive into the operational and strategic challenges faced by smaller, independent research sites and Academic Medical Centers (AMCs) with expert Kristin Surdam. She outlines the significant hurdles in recruitment, oversight responsibilities, and the excessive burden of managing technology stacks and passwords. Crucially, Kristin discusses the implications of sponsor/CRO-provided solutions, such as staff augmentation, and the regulatory oversight responsibilities that Principal Investigators (PIs) must navigate, especially concerning Decentralized Clinical Trials (DCT) elements like home health visits. This episode is essential for those in the clinical research field, offering insights into streamlining processes and enhancing patient-centric research approaches.