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5 Reasons Per Diem Physical Therapy Works for Me

by Brett Kestenbaum, PT, DPT


Per diem physical therapy - "An allowance or payment made for each day you work in a physical therapy job".

Did anyone experience the feeling of being lost following graduation, or was it just me? I didn't know much about all the different career paths for physical therapists and had a limited understanding of the different employment contract types as well. No one ever taught me what type of salary was right as a new grad, or how to look for my first job. I started doing some research once I understood how little I actually knew after graduation and how lost I really was.

This article will cover, from my experience, the basics of per diem work, who should work as a per diem physical therapist, and how benefits are factored in.

Why per diem physical therapy works for me

One question I'm often asked is, "how do you get by without the benefits of a full-time physical therapy position?" In order to answer that, you have to consider what, exactly, are benefits, anyway?

Essentially, benefits, from the perspective of an employee, are another way to get paid. If you have paid time off (PTO) the value is the amount you get paid times the number of days you have off. For instance, if you get paid $300 a day and you receive 5 days of PTO your benefit is worth $1500.

Traditionally, benefits also include healthcare (and sometimes dental/vision care, etc.) as well as retirement savings plans, disability insurance, and sometimes even childcare.

I am a recent graduate and I work as a per diem physical therapist. I get paid hourly and I do not receive benefits. I do not have healthcare paid for by my employer. How does this make sense for me?

Here are the 5 ways that I make it work for me, and I think you should consider working per diem too, especially if this is your first job out of school.

Reason 1 - I get paid at a higher hourly rate

Per diem workers typically earn a (much) higher hourly rate than a typical new graduate physical therapist. That means that my check at the end of the week has more money in it. It also means I pay more tax, but as my grandfather (a CPA) once told me, "the more tax you pay, the better you're doing." Having more money in my pocket and more bills due to the lack of benefits means more responsibility to budget wisely. If I budget properly, I will come out ahead 90% of the time.

Reason 2 - The Affordable Care Act has actually made health care affordable for me

I know it is a touchy subject, but health care reform has allowed me to purchase healthcare at a reasonable rate. As a single male with no family living in California, I pay approximately $275 / month for a decent insurance plan. Is it the best insurance plan out there? Absolutely not. Will I be covered if something devastating happens,? Yes (or at least I hope so!) If I had a family to support, healthcare benefits may be extremely valuable to me. However at this time, it's just me, so I really do not need the benefit.

Reason 3 - I have greater autonomy

As a per diem worker, I can choose when I want to work. That does not mean that I will be able to work every day that I want to, but I know that I have a flexible schedule. I am currently working on several projects (including this website), so a flexible schedule is precious to me. I make sure that I cover the days my employer needs coverage. In my case, it involves a lot of weekend obligations. I want my managers to understand that I am part of their team, and I will always do my best to help out when no one else is available. In return, they provide me with more choice and flexibility when scheduling my other days during the week. And when I wanted to earn extra cash, in the beginning, I had full-time work and even overtime when I wanted it.

Reason 4 - I have the opportunity to work multiple jobs

Currently, I work most of my hours in a hospital, as an acute care physical therapist. I believe this is very valuable as a new grad, which is a topic I will discuss further in an upcoming article. Since I work per diem, I was able to take another opportunity (which happened to be within the same organization) in outpatient neuro. It was incredible to have the ability to learn in both settings at one time. I know of other per diem therapists who can leverage their per diem status by trying out aquatic therapy and pediatrics, without committing to a full-time job in a new setting.

Reason 5 - Higher hourly rate allows me to "pay" for my own days off

Remember we just discussed PTO having a specific value? Well, guess what... I pay for my own days off with the difference in hourly wages I receive. Before taking my job, I took the time to do some very simple calculations. After crunching the numbers I realized that, if I wanted to, I could take about 3 months off and still stay above water. As a per diem therapist, I could make that decision if I wanted to. That sounded pretty good to me.


Per diem physical therapy works for me, because I have only myself to support. I receive a higher hourly wage than an average new grad physical therapist working in San Diego because I am per diem, and I enjoy the flexibility to work on a variety of projects.

You have to decide for yourself what works best for you, but before making a decision, stop to think about it. Really think about what you value, what you need, and what each opportunity means to you.

I recommend using a tool to look at your budget to see if per diem would be a good option for you. There are many budgeting tools out there, and I created one specifically to look at how per-diem pay will affect your budget and cash flow. Click here to access the budget calculator for physical therapists.


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