Setting: Dermatologist office with 3 characters - a nurse, Dr. Smith, the dermatologist, and Mr. Jones, a patient.
Nurse: Dr. Smith. Mr. Jones says he has developed a black spot in the biopsy you did on his thigh last year. He also has a lump in his groin. When should we bring him in? He seemed really worried on the phone.
Dr. Smith: (looks through chart) Oh. The report was at the back of the chart. It says there's a 2.5 mm melanoma and recommends a wider re-excision. We're going to need to bring him in later today. I need to discuss this result.
(Later that day...)
Dr. Smith: Hello Mr. Jones.
Mr. Jones: Hello.
Dr. Smith: Thank you for coming in. How can I help you?
Mr. Jones: I'm a little worried because I found a black mark in my biopsy scar and I also found a lump in my groin. I was wondering if you knew what was going on.
Dr. Smith: Let me have a look at it.
Mr. Jones: What do you think, Doctor?
Dr. Smith: I'm sorry to have to tell you this. You have a recurrence of a skin cancer called melanoma and it has spread to your lymph nodes.
Mr. Jones: (angry) How did this happen? You said that if I didn't hear from you everything was fine!
Concluding facilitation question: Does this represent a disclosure discussion?