This Clinical Consultation Breakfast provides a forum in which current and potential rural child and adolescent psychiatrists can discuss questions, concerns, and problems in the practice of rural child psychiatry. Three experienced rural child psychiatrists discuss their different practice experiences, and share some of the strategies, skills, and values that have enabled them to continue in their practice of rural child psychiatry. Among the areas discussed are the multiplicity of needs and available work for child psychiatrists in rural areas, the realities of rural practice, and strategies for adjusting one's practice to make it viable over the long term, the importance of building in time for family, for continuing education, and for collegial contact and support. This breakfast also highlights the financial realities of rural practice, and issues related to contracts and negotiations, the use of physician extenders, the practicalities of consultation and collaboration with a range of professionals, the dilemmas that result from limited resources, both clinical and financial, and strategies to help upgrade the quality of care available in your area.