The author provides a department chairman's perspective on the opportunities and challenges inherent in the DSM-5 transition. The author discusses these topics in relation to the missions of science, clinical innovation and service, education, community engagement, and leadership. To provide accurate information for their faculty, learners, and staff, chairs will need to provide venues for dialogue, minimize divisiveness, support departmental leaders to help with transition issues, and speak up for patients and the profession in the process.