Frequently we are asked to see patients after they have already undergone an initial evaluation. Often this is to continue a conversation initiated by our colleagues, sometimes to impart additional expertise, and always to assist patients in making decisions. Our role in these settings is multifold: to advocate in the best interest of our patient and to preserve the delicate provider – patient relationship. Cancer screening discussions highlight these principles. One clinical scenario in which this is especially evident is the evaluation of elevated Prostate Specific Antigen (PSA).