The development of leadership and management skills requires a commitment to personal introspection and the development of self-knowledge. Difficult decisions concerning the determination of that which is truly important is central to the process. At both the personal and organizational levels, this process can be facilitated through the creation of a mission statement. Once goals are set and committed to, the realization of these goals is accomplished through a consistent focus on long-range priorities. This paradigm requires prioritizing time and working on activities and relationships that will help to achieve the established goals. In addition, the enhancement of listening skills will prove to be a significant asset in the process of establishing effective leadership. In a very real sense, the future of pediatric emergency medicine will depend on our success in developing these skills.