Table 3.

Hurdles and solutions in achieving cohesive and seamless transitional care.

Transition team member	Possible viewpoints	Possible solutions
Paediatric endocrinologist	Might think that: • Adult endocrinologists are not cognisant of the complexity of the problem • Adult endocrinologists are not willing to provide adequate time for visits/discussion	• All providers need to work together to craft developmentally appropriate healthcare so young patients become more knowledgeable and responsible for managing their conditions • Emphasise physician–patient confidentiality so that teens feel comfortable discussing topics like drug use, misuse, and sexual health
Adult endocrinologist	Might think that: • Paediatric endocrinologists are overprotective and do not sufficiently prepare paediatric patient for move to adult care	• All providers must agree to sharing information and recognising that some overlap is necessary for a seamless conversion • Willing to be flexible with methods of communication with transition patients, e.g., expanded clinic hours to accommodate school/college schedules; use of non-traditional contact methods (email, text)
Parents	• Parents may be unwilling to readily trust a new provider, especially if the adult endocrinologist has not been involved in transitional plan • Parental trust issues can influence the young person	• Include parents in transition process to witness growth of relationship between child and provider and ease concerns about turning over the primary responsibility of healthcare management to patient
Young people	• Young people have become accustomed to allowing parents to manage healthcare consideration • Young people may feel that paediatric endocrinologists have known them and their medical condition for many years and are, therefore, more knowledgeable than the new adult endocrinology provider	• Young people need to become more involved in making healthcare decisions so that they become more adept at managing their disease