The work of pediatrics is changing rapidly. In recent years, we have seen rises in chronic illness and mental health needs among children. The demographic composition of children in the United States is shifting, and our workforce continues to face new internal stresses and external pressures. Pediatricians have also embraced new priorities as we look further upstream to address the social risks and adverse childhood events that dramatically alter the current and future health of our individual patients, and to combat the structural and political determinants of health that continue to perpetuate inequities.