By Brian LaHart, Senior Director of Business Development, Health Carousel
Health systems are right to reduce contingent labor.
With continued pressure on margins, many organizations are focused on lowering traveler utilization, controlling external labor spending, and rebuilding their permanent nursing workforces.
But as hospitals pursue those goals, an important distinction can get lost:
Reducing traveler contracts is not necessarily the same as resolving the workforce need that created them.
Travel staffing remains an essential part of a well-designed workforce strategy. It gives hospitals the flexibility to respond to census fluctuations, leaves of absence, seasonal demand, and unexpected staffing disruptions.
Those are temporary needs, and travel staffing is appropriately designed to address them.
But persistent vacancies present a different challenge.
When difficult-to-fill roles require temporary coverage quarter after quarter, the contract may be short term even when the underlying need is not.
That raises a question worth considering:
Travel contracts may be short term. But is your reliance on them truly temporary?
Flexibility and workforce progress are not the same
The ability to cancel a traveler contract has real value.
Hospitals need flexibility, particularly when patient demand, service requirements, and financial conditions can change quickly.
But contractual flexibility does not automatically produce permanent workforce progress.
An organization can retain the ability to end an individual contract while continuing to rely on approximately the same external capacity because the underlying vacancy remains unresolved.
In that situation, the hospital has preserved flexibility. It has not necessarily reduced dependency.
A three-year commitment is not trivial.
But neither is three years of recurring traveler use.
The difference is not simply the length of the agreement. It is the workforce outcome the agreement is designed to produce.
Not all external labor has the same intended endpoint
This is where broad contingent labor reduction initiatives can become too blunt.
A traditional travel assignment and an international temp-to-perm assignment may both be categorized as external labor during the contract period. Strategically, however, they are designed to accomplish different things.
Travel staffing is primarily designed to provide immediate coverage and short-term flexibility.
International temp-to-perm staffing is a staged workforce-conversion strategy designed to reduce contingent labor dependence over time.
By transitioning clinicians into permanent employment, the model is designed to help health systems reduce recurring dependence on traveler staffing over time.
Although it may be classified as external labor during the assignment, its purpose and intended outcome are fundamentally different: permanent workforce growth rather than recurring temporary coverage.
The hospital gains clinical capacity during the assignment, but the intended endpoint is not another external contract. It is the clinician’s transition into the hospital’s permanent workforce.
Put simply:
Travel rents flexibility. International temp-to-perm builds a path toward durable workforce capacity.
Both approaches have an appropriate place in workforce strategy. The more important issue is whether the staffing model matches the duration and nature of the need.
A more useful way to evaluate external workforce investments
When every external staffing program is evaluated solely as contingent labor, organizations risk treating fundamentally different workforce strategies as though they produce the same outcome.
A program designed to cover a temporary absence should be evaluated on speed, flexibility, and immediate coverage.
A program designed to address a persistent vacancy should also be evaluated on its ability to build permanent capacity, improve continuity, and reduce the need for future temporary labor.
At Health Carousel, we support health systems with both travel and international staffing.
That perspective has reinforced a straightforward principle:
Travel staffing is the right tool for temporary variability. Persistent workforce gaps require a strategy built around a more permanent outcome.
The goal should not be to eliminate every traveler. Hospitals will continue to need flexible labor.
The goal is to be more deliberate about where temporary staffing is supporting true short-term needs—and where it may be carrying a vacancy that requires a different strategy.
Before every externally supplied clinician is placed under the same reduction mandate, leaders may want to ask:
Is this workforce investment extending our reliance on contingent labor—or creating a path out of it?
The answer is not always apparent from the labor category or hourly rate alone.
That is where the more useful workforce conversation begins.
About the Author
Brian LaHart is Health Carousel's International Workforce Solutions Leader, an international workforce leader with extensive experience advising hospital executives on global staffing strategy and workforce planning.
Brian LaHart
