The question is not, as Drs Pastis and Strange1 have suggested, about the best interest of the medical profession; rather, it is about what is in the best interest of the patients. A decade ago, Barber and colleagues2 published their experience in developing the first nurse-led bronchoscopy practice in the United Kingdom. Inspiration to establish this practice was drawn from concerns about inconsistency and rapid turnover of medical trainees, the multiple competing priorities of attending physicians, and the business practicalities associated with facilitating interventional techniques. In other words, they were seeking to optimize quality, access, and cost in the bronchoscopy suite. The curriculum and practical training were deemed to be “safe, well supervised, rigorous and formal.” Eight months after the program was completed, an audit was performed to evaluate the first nurse bronchoscopist’s safety and efficacy. With no adverse events and a 95% histology hit rate, findings compared favorably with published physician bronchoscopists’ results and the standards set forth by the British Thoracic Society. Regardless of the bronchoscopist’s discipline, these findings are consistent with the advice from Ernst and colleagues3 who suggested that procedural volume would beget safety and mastery.