The TMA Board of Trustees and dozens of physician leaders from across the state assembled for a two-day strategic planning session to begin designing and building the TMA of the Future. The meeting was the start of a year-long process that will examine the massive changes affecting the health care system, what those changes mean for Texas physicians, and how TMA can best help physicians prepare for and handle those changes. In addition to the board, the group included various TMA council and committee chairs, coalition leaders, TEXPAC, the Board of Councilors, presidents and staff leaders of county medical societies, TMA Alliance leaders, our consultants, and senior TMA staff. Participants reviewed the outcome of the 2011 Texas Legislature and began preparing for the 2012 elections and the 2013 legislative session. Led by Board Chair Tom Garcia, MD, and TMA President Bruce Malone, MD, they examined how current health care trends will affect TMA membership and the demand for TMA services. They pointed the way toward where we need more research, some ideas that are worth fleshing out for further exploration, and some potential changes that need serious, in-depth vetting. What about you? Please let me know where you think we need to focus our energies. Below is a “word cloud” that summarizes the discussion. The larger a word or phrase appears in the cloud, the more prominent it was in the meeting.