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Pediatric practices traditionally have been designed and staffed to provide acute and preventive care. Adult internal medicine practices see a preponderance of patients with chronic health problems, and presumably have designed their practices to serve this population well. A new analysis compares data from a survey of primary care pediatricians and adult internists who care for patients with multiple chronic conditions. Understanding the similarities and differences between these specialties could be useful in identifying ways to improve chronic care and in preparing patients and practices for the transition from pediatric to adult care.