In 2002, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians jointly published a seminal treatise on transitional care for the medically complex pediatric patient.1 In it they laid the framework for providing comprehensive and coordinated care for the estimated 500 000 children with complex medical conditions entering adulthood annually. Subsequent research has highlighted the challenges with providing this type of transition, finding a decade later that 60% of teenagers with special needs and their families did not receive any structured transitional care planning.2 The root causes of these failures are multiple, including lack of provider awareness or preparedness and a shortage of adult providers familiar with diseases such as cystic fibrosis, trisomy 21, and cerebral palsy. Patient and family reluctance in exchanging a protective, well-established, and nurturing pediatric environment for a more streamlined adult health care model may also...

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