Interactions between clinical research staff and pharma companies are important, as they affect research quality and the recruitment and retention of participants throughout the course of a clinical trial. Research staff has certain expectations about conducting trials, and it’s important for pharma firms to clarify and manage these. To find out how the industry is doing, we asked more than 300 trial sites how well the pharma firms sponsoring their trial met these expectations. We found that sponsors don’t meet all of the expectations research staff has of them; trial sites rated their experiences with pharma sponsors as only “fair”. Pharma needs to change its view of clinical sites: looking at them as customers will open up an array of opportunities to improve operational efficiency and boost recruitment and adherence.