When the patient’s condition is not treated for a long time or the diagnosis is still unclear after multiple tests, the family can propose a consultation to the doctor in charge. Either the hospital or the patient can initiate a consultation. The hospital may or may not notify the patient’s family of the consultation. The patient must inform the doctor in charge of the consultation. How is the consulting physician determined? Most often the doctor in charge determines the consultation, but the patient’s family may also propose a specific consulting physician. The medical office of the hospital will send a letter of consultation to the hospital of the consulting physician after the consulting physician is identified. The cost of the consultation is usually paid by the patient. The exact number of consultations varies from region to region and from doctor to doctor, and can be determined by negotiation.