But Tommy Likes It Here: Moving to Adult Medicine

Publication ID Published Volume
9190 July 3, 2012 8


This 5-page case scenario walks through a typical transition process for a teenager growing into adult with a chronic illness. Barriers and resistance are highlighted on each page and the physician models one way of handling that issue on the next page. The case allows a rich discussion of transition issues including age appropriate care, handling of intrusive parents, feelings of the patient and provider, and problem solving skills.

An outline follows for the discussion leader that outlines which issues are presented on each page to ensure adequate pacing and balance.

Recognition of provider discomfort with transition issues became apparent in our division when we began discussing and studying the issue. The case was designed, based on many years of experience, to capture many key problems that arose.

It was used sucessfully at a Problem Based Learning Luncheon at the American Gastroenterology Association 2011 with excellent feedback from participants. It was also presented as GI Grand Rounds 2011 in our division. We have evidence that discussion of this topic, including this case, led to increased self-managment by patients with IBD (abstract accepted for NASPGHAN meeting in October)


Fishman L. But Tommy likes it here: moving to adult medicine. MedEdPORTAL Publications. 2012;8:9190. http://doi.org/10.15766/mep_2374-8265.9190

Contains Information Suitable for Patient Education

Educational Objectives

  1. Learner can recognize barriers to age-appropriate care.
  2. Learner can develop new strategies to enhance patient self-management.
  3. Learner can reflect on emotions generated in the end of a long term provider-patient relationship.
  4. Learner can develop new strategies to improve provider to provider information during a transfer.


  • Transition, Chronic Illness, Teenager, Inflammatory Bowel Disease


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ISSN 2374-8265