The ability to perform procedures is one of the defining characteristics that attracted so many of us to fellowships in pulmonary medicine, critical care medicine, and thoracic surgery. In fact, nearly 500,000 bronchoscopies are done each year in the United States. Additionally, approximately 15,000 airway stents are placed yearly worldwide. The number and complexity of procedures that can be performed in the bronchoscopy unit is increasing. For example, endobronchial electrocautery for tumor ablation and the treatment of hemoptysis can be performed under local anesthesia during a “routine” outpatient bronchoscopy.