In Arthritis Research & Therapy, Gavigan et al. report on Rheumatoid Arthritis (RA) patients’ beliefs on factors that influence their physician’s treatment decisions, reasons patients tolerate sub-optimal disease control, and perceived barriers to treatment optimization. Eligible participants were enrolled in the ArthritisPower registry and completed a survey on barriers to treatment optimization and patient-reported outcomes on symptoms of fatigue, sleep disturbance, and physical function. Most participants trusted their doctor’s treatment decisions and prioritized their physician’s treatment goals over their own.