None of us can predict what the future holds. However, as an agent of change, occupational therapists will not only strengthen the profession, they will make a significant difference to the health, well-being, and occupational outcomes of the people and communities we serve. I suggest the challenges ahead include: how and where we practice, how to be more responsive in the bi-cultural context, how to educate the next generation of occupational therapists, how to support and develop leaders, and how to build a stronger profession. Our success in the changing world will require reform, responsibility, and innovation. "He waka eke noa" - we are all in this same boat together.