Much has been written about the process of transitioning pediatric patients to adult care clinicians.17 Although the theoretical process for transitioning these patients may be well understood, the reality of transitioning patients with complex health care needs is in fact a much more difficult process than transitioning otherwise healthy patients. Not only is finding a new primary care clinician extremely difficult,8 coordinating transition for all other specialists, therapies, and routine procedures is as well. Expecting families to tackle all of this on their own is neither realistic nor patient centered. At the same time, the amount of time and energy it takes for a clinician to do this, even with the assistance of care coordinators, can be daunting. This article and case discussion present the realities of an extremely complex pediatric patient and the lessons learned through the process of transitioning her to an adult clinician from the perspectives of her primary care pediatrician (Dr Sheldon Berkowitz) and her mother (Pat Lang).

Maddie is a patient with complex health care needs, all of which resulted from a history of pediatric- and infantile-onset metachromatic leukodystrophy, for which she underwent 2 bone marrow transplants in 2001 and 2002. Dr Berkowitz assumed her care when she was 15.5 years old and served as her primary care physician until transition occurred to an adult clinician when she was 21 years old. At the time of transition, her medical history included 30 past and current medical problems,

Address correspondence to Sheldon Berkowitz, MD, FAAP, Childrens Minnesota, 2540 Chicago Ave S, Minneapolis, MN 55404. E-mail: sheldon.berkowitz{at}childrensmn.org

View original post here:

Transitioning Patients With Complex Health Care Needs to Adult Practices: Theory Versus Reality - AAP News