When and How to Use Per Diem and Contract Staff in Your Clinic
Small clinics face a staffing paradox. They rarely have enough volume to justify a full additional FTE in certain roles, but they frequently have enough demand to be understaffed at critical points. Per diem and contract staff are one of the tools available to navigate that gap, and they are worth understanding clearly before you need them.
When Per Diem and Contract Staff Make Sense
There are three situations where flexible staffing genuinely solves a problem.
The first is covering planned absences. When a full-time staff member goes on leave, the work does not pause. A per diem employee who has already been oriented to your systems can step in without the ramp-up time a brand new hire would require.
The second is managing seasonal or cyclical volume. Some clinics see predictable volume spikes tied to flu season, grant reporting periods, or patient enrollment cycles. Adding temporary capacity during those periods avoids both the cost of permanent overstaffing and the strain of asking your core team to absorb unsustainable workloads.
The third is filling a gap while a permanent hire is recruited. Clinical recruitment in small markets can take 60 to 90 days or longer. A contract employee or locum provider in the interim maintains patient access and revenue.
The Hidden Costs of Flexible Staffing
Per diem and contract staff are not simply more expensive employees. They carry a different set of costs that are easy to underestimate.
Orientation and onboarding take time even for experienced staff who are new to your systems and workflows. A per diem medical assistant who has never used your EHR is not fully productive on day one. Build onboarding time into your planning.
Quality consistency is also a real concern. A temporary employee who has not been trained to your documentation standards or patient communication expectations may introduce errors or patient experience problems that your permanent team would not.
Managing Flexible Staff Well
Treat per diem and contract staff as you would any member of your team during their time with you. Give them a clear orientation, access to the resources they need, a point of contact for questions, and direct feedback if expectations are not being met. Staff who feel professionally respected perform better and return when you need them again.
What to Do Next
If you are currently managing a staffing gap or anticipating one, identify whether the gap is best addressed by a per diem arrangement, a contract placement, or a permanent hire. The timeline of the need and the complexity of the role are the two most important variables in that decision.
If you want support thinking through your staffing model or navigating a current gap, our team can help.