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The role of the pediatrician is to prepare the adolescent for transition, making it progressively clear that she/he will not be the referral physician, and that this idea should be accepted by the young person affected with the chronic condition. One way to pass on the information is to see the adolescent alone, when she/he and the parents agree. This, by itself, conveys the message of a change from the usual consultation that the adolescent had as a child, not being alone with the pediatrician. The “triad” (child, parents, pediatrician) is changed to a “diad” relationship with the pediatrician, as will happen later with the physician for adults.

This process will also convey a message that autonomy is now important to prepare the transition.

The role of the pediatrician is then to find the right physician for adults, for the adolescent she/he has known for a long time. She/he should take into account the referral physician according to the disease in question but also discuss whether the adolescent, who has now become pubertal, would choose a female or male physician (if possible in the department of adult medicine). In any case the pediatrician should identify a physician who is willing to invest time in the process (these consultations for transition are often longer than the usual ones).

Some documentation of the medical history and treatments should be shared with the adolescent and the physician for adults. This is often a good time to read before transition those documents with the adolescent to avoid any feeling of secrecy from her/him.

This process of transition is needed as the pediatric milieu is not the best to fully develop autonomy, the social and professional integration of the young adult. In general, the pediatrician is more involved in growth, puberty, and familial relationships whereas the physician for adults will also focus on fertility, autonomy, and profession.

It is also very important for the physician in adult medicine that feedback on the evolution of the young person should be given to the pediatrician.