Edward Schor’s recent commentary raises questions about the age cutoffs for transitioning from pediatric subspecialty care. We recognize the current difficulties of maintaining continuity of care for young adults with complex congenital conditions aging out of pediatric care without adult providers comfortable in assuming their care; however, we believe the solution is multifaceted and should not be addressed by broadly extending the age cutoffs for all pediatric subspecialty care. Unfortunately, the population of children with congenital complex conditions was not well defined in Dr Schor's commentary; he referenced the American Academy of Pediatrics/American Academy of Family Physicians/American College of Physicians Clinical Report on Transition, which incorporates a broad population of youth with special health care needs (YSHCN). Thus, Dr Schor implies that most YSHCN should be cared for by pediatric providers. We agree that having pediatric subspecialists provide care over the life course for the small number (0.4%) of...

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