When three leading gastroenterological associations issued a statement advocating physician-supervised, RN-administered propofol for endoscopy, I was shocked. Propofol is riskier than anesthetic regimens traditionally administered during endoscopy. There's also the possibility no code team will be in place in an office environment. If you then burden the physician with RN supervision on top of the clinical risks of an aging population, you place hundreds of thousands of patients at unnecessary risk.