In my experience with RDS as a MySQL admin, Amazon was not using sane defaults for quite some time, which resulted in a remarkably non-performant product. Thankfully, they listened to feedback, so over the course of a few years the MySQL RDS instances started to become much more dependable and useful. I'd be happy to use one today, which is something I couldn't have said too long ago.

And even with RDS, having a DBA available (even just as a consultant) is still quite useful - it's unrealistic to expect your developers to write ideal SQL. You can get a long ways with RDS if your queries and schemas are well tuned.