It depends on the use case. In our experience, it's been rare that queries on PII need to do anything more complex than substring matching (which we're working on support for). We're definitely not trying to be able to encrypt every column, just to make some common workflows around PII and PHI a lot easier.

Custom views can help, but it does mean you're dealing with access controls directly in the database which can be hard to manage. And the database is fully exposed through backups or engineers with server access.