I was chatting with a practice owner in Indy last week who almost dropped her coffee when she saw the current day rates for a temporary hygienist. Honestly, I can’t blame her.
We’ve all seen the shifts coming, but seeing the actual 2026 numbers on paper is a different kind of reality check. If you’ve been feeling like your staffing budget is a moving target lately, you’re not alone. The “new normal” for locum rates is officially here, and it’s a lot stickier than we hoped it would be.
Why the sticker shock is real this year
Here’s the thing: we aren’t just dealing with a “busy season” anymore. We are looking at a fundamental shift in how dental professionals want to work. By the time we hit March 2026, the clinician shortage reached a point that’s hard to ignore. We’re looking at a projected shortfall of nearly 4 million healthcare workers across the board.
In the dental world, that translates to fewer hands at the chairside and a lot more competition for the talent that’s available.
When supply is this tight, rates go up. It’s basic economics, sure, but it feels a lot more personal when it’s your P&L statement on the line. I’ve seen practices try to hold out, hoping rates will “correct” themselves. But the data shows these rates are staying high because the demand hasn’t blinked. If you haven’t adjusted your 2026 budget yet, you might find yourself in a tight spot when that inevitable last-minute call-out happens on a Monday morning.
The budgeting nightmare no one warned you about
Most of us build our budgets based on last year’s data. In 2026, that’s a recipe for a headache. Inflation is still doing its thing, and the “payer mix” (that lovely blend of insurance reimbursements and out-of-pocket fees) isn’t exactly keeping pace with the cost of labor.
And honestly? It’s a tension point.
Hospitals and large dental groups are feeling the squeeze too. They’re caught between needing to fill seats to keep the revenue flowing and the rising cost of the people in those seats. As a practice owner, you’re essentially competing with deep-pocketed organizations for the same pool of locum tenens providers.
If you’re still budgeting $45 an hour for a temp hygienist in a high-demand area, you’re going to be left with an empty operatory. We’re seeing day rates climb steadily because providers know their value. They see the 1997 Medicare funding caps that limited residency programs, yes, we are still feeling the effects of a decision made decades ago: and they know there just aren’t enough new clinicians entering the pipeline to fill the gap.
The “Tax Surprise” waiting for new locums
I want to pivot for a second to the providers: the clinicians who are jumping into the locum world for the first time. 2026 has seen a huge surge in “career locums.” It sounds like a dream, right? High day rates, total flexibility, and no office politics.
But here’s the kicker: the tax bill.
I’ve talked to so many talented dental assistants and hygienists who transitioned to locum work and got hit with a massive, unexpected tax bill because they were classified as 1099 contractors. When you’re an independent contractor, that “higher” hourly rate can be deceptive. You’re responsible for the employer’s share of Social Security and Medicare taxes.
And honestly, it hurts.
That’s why we take a different approach here at RSMC Services. We know that financial stability matters for the people doing the work, not just the people paying the bills.
When we offer W-2 positions with weekly pay, it takes that “tax nightmare” off the table for the provider. If you’re a clinician looking at these climbing rates, make sure you’re looking at the net income, not just the gross. A high 1099 rate might actually leave you with less in your pocket than a solid W-2 rate after all the paperwork is done.
The balancing act: Cost vs. Quality care
So, how do you handle this as a practice manager or owner? You can’t just stop hiring. An empty chair is the most expensive thing in your office. If you aren’t seeing patients, you aren’t making money, but your overhead: the rent, the utilities, the software: stays exactly the same.
The temptation is to find the “cheapest” possible help. But I’ve seen that backfire more times than I can count.
When you prioritize a low rate over a high-quality clinician, your patients feel it. Your permanent team feels it. A locum who doesn’t know their way around your software or lacks the “soft skills” to put a nervous patient at ease can cost you more in lost reputation than you saved in hourly wages.
Here’s my advice: Budget for quality.
Instead of seeing locum costs as an “emergency expense,” start seeing them as a strategic part of your operations. If you know that rates are climbing, build that 5-8% increase into your 2026 forecast now. It’s much easier to explain a planned expense to your partners than it is to explain why you’re $20k over budget in Q3.
How to protect your 2026 margins
You don’t have to navigate this alone. The “rate tension” we’re seeing in the industry is real, but there are ways to manage it without losing your mind (or your profit margins).
1. Audit your current staffing levels: Are you leaning on locums because of a temporary gap, or is there a deeper turnover issue? Sometimes, investing in your permanent team’s culture can reduce your reliance on high-cost temp help.
2. Plan for the “Tax Hit”: If you are a provider, start putting aside 30% of every check if you’re on a 1099. If you’re an owner, consider working with an agency that handles the W-2 side of things to keep your compliance clean.
3. Be Transparent: If you’re a practice owner, talk to your staffing partner about your budget constraints. At RSMC, we work with you to find a balance that keeps your chairs full without breaking the bank.
4. Look at the Long Game: The clinician shortage isn’t going away by 2027. This isn’t a “wait it out” situation. It’s a “build a better system” situation.
Let’s get your budget back on track
I know it’s a lot to digest. Running a dental practice in 2026 feels like juggling chainsaws sometimes, especially when the cost of those chainsaws keeps going up.
Whether you’re a practice owner trying to make sense of your payroll or a dental professional trying to navigate the locum life without getting burned by the IRS, we’ve got your back. We live and breathe this stuff every day, and we’ve seen every side of the 2026 market.
If you’re feeling the squeeze or just want a second pair of eyes on your staffing strategy, feel free to reach out to the RSMC Team. We can help you navigate these rising rates and find a path that works for your practice and your patients.
Give us a call at +1 650-447-1527 or send over an email to careers@rsmcservices.com. You can also check out our contact page to get the conversation started.
And honestly? Don’t sweat the numbers too much. With a little bit of planning and the right partners, your practice will do just fine.
Talk soon,
The RSMC Team rsmcservices.com