In taking a look at the overall process of adding employees, there are many hidden costs. First the time to review resumes and the hiring process. This can include background checks, drug testing, and other pre-employment work and administration.

Once the employee is hired, you have to set up payroll for them. There will be the cost to complete the payroll itself, whether you do this in house or outsource. This can be as much as $25 to $100 per week depending on your staff size.

You will pay Social Security tax in the US, which runs typically 6% of the salary (or wages) of the individual, Medicare Tax with is 1.45% of their salary, State Unemployment of approximately 2.7% of wages, Federal Unemployment and workers compensation. These will vary by state and will likely even be more as you leave the United States and work in other first world countries. The point being, is that your cost base rises given local labor laws.

Depending on your country there will be time given for vacation, sick days, medical and other benefits. Bottom line, as your office expands, outsourcing areas that are not directly customer or patient facing can have merit. Contractors will be invoiced only for work performed, and you can turn it on and off as needed. That's where Vinna comes in. You. Win.