What contract medical physics actually costs — and when it beats hiring.
Every administrator weighing outside physics asks the same thing: is contracting actually cheaper than hiring? The honest answer depends on one number most people never calculate — and the sticker price on a contractor is the wrong thing to look at.
The full-time number is bigger than the salary
A board-certified therapeutic medical physicist earns a median near $245,000 (AAPM 2024). But salary isn't the cost of the seat. Load in benefits, payroll taxes, and overhead; add the instrumentation, calibration, and continuing education that follow the person rather than the post; and a single full-time seat runs $300,000 to $350,000 a year — more for a chief. That is the number to compare against, not the salary line.
The comparison trap
Here is where centers go wrong. They take a contractor's day rate, annualize it in their head, and it looks expensive. But that comparison quietly assumes the contractor works the same hours as the full-timer — and that the full-timer is fully used. Neither is usually true. A contractor's rate already covers their own benefits, instrumentation, malpractice, and downtime, none of which you carry — and you pay only for the hours your program actually consumes.
Utilization is the whole game
The real question isn't "cheap physicist or expensive physicist." It's: how much physics work does your program actually generate? A high-volume, multi-machine department can keep a physicist genuinely busy every week, all year. A single-linac center, a rural program, or a department covering a leave cannot. If your program produces half a physicist's worth of work, a full-time hire means paying full salary for half a seat. Fractional coverage sizes the cost to the work:
- Weekly chart checks and independent second-checks
- Patient-specific QA (IMRT, VMAT, SBRT, SRS)
- Monthly and annual machine QA
- Program design, documentation, and accreditation-survey prep
The hours the program consumes — and nothing you don't.
When hiring wins (the honest part)
Contract isn't automatically cheaper. Once a center's physics load approaches a full FTE — enough recurring work to keep someone busy week after week — employing becomes the more economical choice, and you gain the continuity of a dedicated person. A large center with that volume should hire. The argument here is narrower: most centers aren't that center, and they have only ever been quoted the full-time option.
The cost nobody prices
There's a third number that dwarfs both: the cost of no coverage. A physicist departure that halts treatment, a missed QA that surfaces at survey, a compliance gap that becomes a citation — those are far more expensive than either staffing model. For many centers the real comparison isn't contract versus hire. It's coverage versus exposure.
How to actually decide
Three questions usually settle it: How many machines, and what volume? What is your current physics staffing, and what gaps does it leave? And what does your state require to be on-site? Answer those honestly and the right model is usually obvious — sometimes fractional, sometimes a hire, often a hybrid.
Tell us your machines, volume, and current staffing, and we'll map the real physics load — and quote coverage scoped to it, not to a salary. If the honest answer is that you should hire someone outright, we'll say so.