So, on a tangent from statistics and not relating to names, management or critical appraisal, I was wondering about transition of adolescents from paediatric care to adult specialities, and was filled with a sense of loss.

There have been lots of people tell stories of how the move away from the managed care of community paediatrics left their child with a chronic illness and disability lost and confused. There are tales of worse outcomes in some chronic diseases, and reviews of how transition can be effectively undertaken, but I’ve not noticed a narrative on the experience of the health care practitioners.

When our adolescent patients, perhaps looked after by us for most of their lives, become to old to be seen with CBBC in the waiting room and crayons on the desk, is part of the challenge in transition our proxy-parent-feeling for our patients? Do we fear them walking unaccompanied in the dark corridors of adult medicine, or seeking their own physical therapy? Do we not want to experience an empty nest around transition?

– Bob Phillips

(Comments clearly welcome…)