The decision
An agency or staffing company may manage matching and workforce administration while your practice directs daily tasks. A marketplace primarily helps you find candidates. A direct-hire arrangement moves more of the ongoing relationship to the hiring organisation. Providers use these terms inconsistently, so confirm the actual contract.
What to compare
Compare responsibility for payroll administration, replacement, training, equipment and absence cover. Ask whether a provider supplies a managed service outcome or a person whose work you supervise. Those models can carry very different obligations even when both use an hourly price.
Before you commit
Before choosing, identify who will manage the assistant inside your practice. A well-matched candidate still needs instructions, feedback and escalation support. Paying for placement does not automatically purchase a fully managed department.