Healthcare Staffing Models Explained: Per Diem, Travel, Contract and Permanent
Per diem, travel, contract, locum tenens and permanent healthcare staffing explained — how each works, when to use it, and how to build a balanced workforce.
Key takeaways
- Healthcare facilities typically blend permanent staff with flexible per diem, contract and travel workers.
- Per diem fills individual shifts; travel and contract cover longer gaps; locum tenens covers physicians.
- Flexible staff solve short-term gaps but cost more per hour — permanent hiring builds stability.
- Credential verification and onboarding must be just as rigorous for flexible staff.
Per diem staff work individual shifts as needed. Contract staff commit to a fixed assignment for weeks or months.
Patient volumes rise and fall. Staff take leave, retire or move on. Most healthcare organizations need more than one staffing model to keep care safe and costs under control. Here's how each model works.
What are the main healthcare staffing models?
| Model | How it works | Typical length | Best for |
|---|---|---|---|
| Permanent | Employees on your payroll | Ongoing | Core teams and continuity of care |
| Per diem | Clinicians pick up individual shifts as needed | Shift by shift | Daily fluctuations, call-outs |
| Contract | Fixed-term assignments, often local | Weeks to months | Leave cover, new programs |
| Travel | Clinicians relocate temporarily for an assignment | Often around 13 weeks | Hard-to-fill or seasonal gaps |
| Locum tenens | Temporary physicians and advanced practitioners | Days to months | Physician vacancies and coverage |
What is per diem staffing?
Per diem ("per day") staff work individual shifts on an as-needed basis. They give facilities quick flexibility for daily ups and downs — sick calls, surges or weekend gaps — without long-term commitments.
What is travel staffing?
Travel clinicians — often nurses and allied health professionals — take temporary assignments away from home. Travel staffing helps fill hard-to-fill or seasonal roles, especially in areas with local shortages. It is usually more expensive per hour than local hiring.
What is locum tenens?
Locum tenens ("to hold the place") places temporary physicians, nurse practitioners and physician assistants. It covers vacancies, leave and new services while you recruit permanently.
How do you choose the right staffing mix?
Build a stable permanent core, then use flexible models for variability.
- Forecast demand by unit and season.
- Staff the predictable baseline with permanent employees.
- Cover daily swings with a per diem pool.
- Use contract or travel for known longer gaps.
- Review costs monthly — heavy reliance on premium labor is a signal to invest in permanent hiring and retention.
What about licensing and compliance?
Every clinician must hold valid credentials for the state where they practice. The Nurse Licensure Compact (NLC) lets nurses with a multistate license practice in participating states, which can speed up cross-state staffing — but not every state participates, and rules change. Verify licenses, certifications and background checks for flexible staff just as carefully as for permanent hires.
How does technology help?
AI-powered recruitment helps build and maintain pools of qualified clinicians, match them to open shifts and roles, and keep credentials tracked. Read more in the future of healthcare staffing.
How RPO Provider helps
We recruit permanent and flexible healthcare talent — nurses, allied health, physicians and life sciences professionals — with credential checks built in. See healthcare & pharma staffing, or our market guides for Florida and New Jersey.
FAQs
What is the difference between per diem and contract healthcare staffing?
Per diem staff work individual shifts as needed. Contract staff commit to a fixed assignment for weeks or months.
How long are travel nurse assignments?
Assignments commonly run around 13 weeks, though shorter and longer contracts exist.
What does locum tenens mean?
It's Latin for 'to hold the place' and refers to temporary physicians and advanced practice providers covering vacancies or leave.
Is flexible healthcare staffing more expensive?
Per hour, usually yes. It's cost-effective for short-term or unpredictable gaps, but long-term reliance is typically more expensive than permanent hiring.
