The Temp Trap: What Your Recruiting Strategy Is Costing You
I hear some version of this almost every week from practice owners and even some DSO CEOs:
"We don't really use a recruiter. When we need someone, we just call the temp agency. If we like who they send, we offer them the job."
I understand the logic. Your hygiene chair is empty. Patients are scheduled. You can't afford a gap in production. The temp agency picks up the phone, sends someone within 24 hours, and the chair gets filled. It feels efficient. It feels controlled. It feels like you're not committing to the wrong person.
Here's the problem: what feels like the low-risk option is often the most expensive one. I’ll show you the math.
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Why the legacy dental recruiting model “feels like” it works
Let's be fair to the approach, because it does solve a real problem.
When a team member leaves — or worse, when you let someone go and immediately start second-guessing whether you can find someone better — a temp fills the production gap quickly. Patients get seen. The schedule doesn't collapse. You don't have to cancel appointments and explain the situation to your front desk. On paper, the chair is covered.
The appeal goes further than that. There's a "test drive" logic embedded in the model: see how this person works in your environment before you commit. Watch how they interact with patients. See if they fit your culture. If it doesn't work, you just don't call them back.
It sounds almost like a no-strings audition.
The reality is considerably more expensive.
The real cost of the temp carousel
I call it the Temp Carousel because that's what it becomes for most practices. One temp, then another, then another. Each one filling the chair for a day or a week while you hope the right person eventually turns up. Here's what that carousel actually costs.
The Rate Premium You're Paying Every Single Day
Temp agencies charge a significant premium over what you'd pay a direct hire. For a dental hygienist, the agency rate typically runs $85 to $110 per hour — compared to a direct salary of $60 to $80 per hour for a permanent employee.
That's a daily premium of $200 to $400. Every day.
Over 60 days of cycling through temps while your position goes unfilled, you've spent $12,000 to $24,000 in excess labor costs before making a single permanent hire.
And that's before we discuss what happens if you actually find someone you want to keep.
The Conversion Fee - (IF there IS one - not always applicable anymore!)
When you find a temp you love — when someone finally clicks — some temp agencies do not just let you hire them. There's a conversion fee – if it’s an associate dentist, typically 5 to 25 percent of the new hire's first-year salary. Admittedly some temp agencies are waiving the conversion fee for dental hygienists and other dental staff.
For a dental hygienist earning $55 per hour, that's roughly $114,000 annually. The conversion fee: $17,100 to $28,500 — due at the time of hire.
So the temp strategy, when it "works," costs you a premium every day it runs, and then a potential substantial lump sum when it concludes. The chair was never actually free.
The Production You Think You're Preserving — But Aren't
This one surprises people. The whole point of the temp is to keep the chair producing, right?
Except temps produce at roughly 75 to 85 percent of what a permanent, integrated employee delivers.* They don't know your systems. They don't know your instrument preferences, your documentation protocols, your patient flow. They certainly do not care about if the patient in your chair accepts treatment the doctor diagnosed. They are clinically competent — but they are not dialed-in, or bought-in to your practice.
At $1,200 per day in normal hygiene production and 80 percent efficiency, you're absorbing a $240-per-day production gap.
Over 60 days, that's $14,400 in production you thought you were keeping — but weren't.
The Cost Nobody Puts on an Invoice: Patient Drift
All of the above shows up somewhere — in agency invoices, in payroll, in unrealized production reports. The most damaging cost doesn't show up anywhere.
Except in active patients.
Your patients have a hygienist.
Not "the hygienist available today." Their hygienist. The one who remembers they get anxious about the Cavitron. Who asks about their daughter's soccer season. Who has watched their recession progress over three years and knows which quadrant to watch. Who greets them by name before they've reached the front desk.
When patients call to schedule and discover it's a temp — again — some of them reschedule for later. Some let the recall lapse a little longer than usual. Some accept the appointment but no-show. Many of your patients, quietly and without drama, start wondering whether there's a practice nearby where things feel a little more consistent.
They don't complain. They don't cancel dramatically. They just slowly drift.
And then there are the new patients — referrals from your best long-term loyalists who called their friend and said "you have to come see my dentist." That new patient shows up for their first appointment and meets a different person than the one their friend described. The experience is fine, but it's not personal. There's no warmth that comes from being known. They get their cleaning and they say they'll schedule again.
Sometimes they do. Sometimes they don't.
At 10 patients lost to quiet attrition over a cycle of heavy temp use, you're looking at $42,000 in lifetime value. With no line item attached.
The Orientation Tax Nobody Budgets For
Every new temp requires 30 to 60 minutes of orientation from your office manager or a senior team member. Software access, room setup preferences, which patients need extra time, how you handle radiograph protocols, where the sterilization flow goes.
Multiply that by 15 or 20 different temps cycling through over a few months. You're looking at 10 to 20 hours of your leadership team's time — invested in people who aren't being recruited. At a conservative $150 per hour opportunity cost, that's $1,500 to $3,000 spent orienting temporary strangers.
Side by Side: What the Math Actually Looks Like
Cost Category | Temp-as-Recruiting (60 Days) | Fit-Based Recruiting
Agency rate premium | $2,304 per week (RDH) | $0
Conversion fee (when successful) | $3-5k (RDH) | $0
Production efficiency gap | $1,000_ per week (RDH) | ~$7,200 (normal ramp) |
Patient attrition (10 patients risked daily) | $42,000 | $0–$10,000 | (Annually $538 in smaller practices to over $1,300 in larger health systems, according to Burkhart. Total value increases significantly when accounting for a 10-year lifespan ($7,000–$14,000+) and referrals. For estimation purposes, if 1 in 20 leaves that is 1070- 2,600 per week risked (RDH)
Orientation time | team stress / morale / retention
Burkhart Dental Supply +2
Total: $4,374 - $17,104 per week (RDH)
Plus 10% new tax in WA on temps = 5k = 20k (RDH) for one week.
| Total | $87,000–$111,900 | $3,000–$18,700 |
The temp trap costs two to 4 times more per week than finding the right fit the first time. It just doesn't feel that way because the costs arrive in fragments — a daily invoice here, a production gap there, a few missed recalls nobody notices until quarter-end.
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There's a Strategy Problem, Too
Beyond the math, the temp model has a fundamental strategic flaw: it optimizes for today's filled chair at the expense of your long-term patient relationships.
And it doesn't actually recruit. It hopes.
Most dental temps aren't looking for permanent placement. They've built their work life specifically around the flexibility of temporary work. The "test drive" model assumes you'll eventually find a temp who (a) performs well, (b) fits your culture, (c) actually wants a full-time role, and (d) wants that role with you specifically. The odds of all four converging are not in your favor.
The practices I see spinning their wheels in the temp carousel for six, twelve, even eighteen months aren't doing it because it's working. They're doing it because no one has shown them a better way to think about the risk.
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The Alternative: Recruit for the Right Fit, the First Time
The data on hiring is clear: the number one predictor of whether a hire stays and thrives isn't technical skill — it's personality fit. Specifically, how their core motive aligns with the team they're joining and the leadership style they're working under.
A temp agency places whoever is available. They're matching a credential to a vacancy. They're not evaluating whether this person's communication style will work with your office manager. They're not asking whether a high-energy Yellow personality will clash with your Blue-heavy clinical team. They're filling a slot.
Recruiting for fit means doing the work to understand not just can this person do the job — but will this person thrive in this specific practice, with this specific team, under this specific dentist. Those are very different questions. And the answer to the second one is what determines whether you're talking about a three-year retention or a three-month revolving door.
When you get that right the first time, you don't pay the agency premium. You don't pay the conversion fee. Your production ramps to full efficiency faster. Your patients build a relationship. Your team stabilizes. And you stop investing thousands of dollars in orienting temporary strangers.
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The Number That Should Matter
You're already paying for the gap in your schedule.
The only question is whether you pay (much less) to fill it properly — or, pay $87,000 to $111,900 to fill it temporarily, repeatedly, and at the cost of the patient relationships that make your practice worth coming to.
The right hire isn't just good for your team. It's the best investment your practice can make.
— Barb Morgen | Thrive Dental Recruiting Founder | Color Code Certified Trainer*
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Barb Morgen is the founder of Thrive Dental Recruiting and a Color Code Certified Trainer specializing in fit-based hiring for dental practices and DSOs. If your practice is caught in the temp carousel — or if you're a private practice facing an upcoming opening on your team, and you want to get it right — reach out at barb@thrivedentalrecruiting or visit www.thrivedentalrecruiting.com.