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When I reviewed Cornerstone I discovered it allows variable rates of commission from categories to individual items.  This is logical since each service or inventory item has a different profit margin. The items with a higher margin or stimulates other services like U/S does for surgery we offer a higher commission rate. All the benefits etc. I just standardize it and reduced the bickering.  We pay usually a lower rate which enables us to hire more staff to delegate some of the work.  The increased staff enables the doctor to increase production and ultimately increase their own salary without totally busting their butt.  The staff enjoy more than just holding dogs and cleaning counters and the doctor uses their brain more than their back.  You have to be careful not hire too many doctors for your practice size or salaries could drop.