By Debbie Bunch
December 2025
As a respiratory therapist, you have a wealth of options when it comes to career choices. One that many therapists try at least once in their careers is working per diem, often part-time, to earn extra cash to supplement their full-time job.
But could it also be your only source of income? Consider these pros and cons before going per diem full-time:
The Upsides
- The pay is significantly better: Because employers do not provide benefits like vacation time and health insurance to their per diem employees, you’ll make more money going the per diem route. If you have a spouse who covers your insurance needs, this may be an attractive option.
- You can work when you want: Per diem therapists can pick and choose which shifts they want to take, making it easier to fit work responsibilities around life responsibilities, such as child rearing or returning to school. It’s easier to schedule vacations and other fun activities as well when you know you can say no to work.
- You aren’t stuck in one setting: If you enjoy stepping into new situations, then per diem work may provide you with the diversity you are looking for to maintain your engagement in the profession. You may even get the chance to travel outside of your current location to take on new jobs.
- You get to see RT in action in several facilities or units within facilities. This is particularly useful if you are still on the fence about which area of respiratory care you’d like to specialize in. You’ll get the chance to experience life as many different kinds of therapists, from adult acute care to pediatrics.
The Downsides
- You are not likely to receive any benefits: While per diem therapists do make more money, they also have to cover their own health insurance costs and don’t get paid time off or the chance to participate in employer-matched retirement plans. These factors must definitely be figured into any decision to make per diem work your only source of income.
- There is no job security: Per diem therapists are brought in only when hospitals or other facilities cannot cover their shifts with the therapists they have on staff. There will be times when your services are in demand and other times when you will not be called to work for many days in a row.
- You will constantly be faced with new coworkers and new work units: If you feel most comfortable working with colleagues you already know, then per diem work might not be for you. As a per diem therapist, it is harder to make meaningful connections with your fellow therapists or other members of the health care team, and you may find yourself on the outside looking in.
- You may still need to adjust your personal schedule to take jobs: Per diem therapists may be in greater demand when full-time staff are not, such as nights, weekends, and holidays, and peak vacation times. This means that, to make ends meet, you may need to take shifts when you would rather be spending time with friends and family.
- Shifts can be cancelled at the last minute: Because per diem staff are intended to fill in only when no other solution can be found, sometimes you will discover your shift is cancelled because the facility did find another solution, or perhaps the hospital census changed for the better that day.
So, consider these factors before going per diem full-time. It’s an excellent fit for some people, but not everyone’s cup of tea.
