THE TREND TOWARD outpatient surgery continues to rise. Medicare is encouraging more procedures in the nonhospital environment. Today surgery is performed in the surgical office that only 5 years ago would have been considered more appropriate for hospital operating rooms. These include orthopedic, obstetric, gynecologic, and cosmetic procedures. While many specialties that were reared in the traditional hospital operating room culture are now venturing into the office practice environment, dermatology by its very nature has lived in that world from the outset. Our specialty training is geared toward developing expertise in both outpatient medical and surgical treatment. A recent survey by the American Society for Dermatologic Surgery found that its members performed about 3.9 million procedures. Of these, skin cancer surgery was the most common with 1.4 million operations, suggesting a broad range in the nature of surgery performed by dermatologists in their offices.1