I am writing to give an opinion regarding the COPN in Virginia. Having moved from a state that did not have a COPN (Arizona) to one that does (Virginia); I can fully see the advantage of not having a COPN and the detriment to the patients of having one.  I was in practice for 14 years in Tucson, AZ. There was no COPN and therefore many groups had CT scans and MRI scanners as well as surgery centers. From a physician perspective, when I needed a CT scan performed, I could always find a place that could accomodate the patient by the next day. This alleviated anxiety and in many cases was life-saving as well as cost-saving by the patient not ending up in the ER at one of the hospitals to have the test done urgently. Because of the number of scanners around, those that did best were those that accomodated the patient the most. As a result, one could get scans on Saturdays and early mornings or late evenings. The patient 100% benefited and were very happy. We as physicians were very happy with utlizing this care as well. This same held true for surgery centers.  Medical care was much more driven by patient satisfaction in Arizona and less so by unnecessary regulation. There was no evidence that physicians over-utilzed this service because of the increased competition. That should be of no worry these days due to increased cost responsibility on the patient and the patient now being the requlator of their own care due to finances. If I can answer any questions, please feel free to contact me. Thank you for your time.  BAR