This is a review of basic principles applicable to the use of propofol by trained endoscopists and nurses for endoscopy, without the involvement of an anesthesia specialist (an anesthesiologist or certified registered nurse anesthetist). The review also explicitly describes the nature of the current controversy surrounding the use of propofol by endoscopists, implies its origins in financial incentives, and outlines obstacles to the use of endoscopist-directed propofol.