Respiratory care directors are now becoming experts in staffing models that are unique to services provided through allied health professionals. The basic human resource management tenets of attract, retain, and motivate remain at the core of management focus; however, time standards, volumes, staffing variables, and flexible budgets are the current twists added to the litany of labor management terms. Optimizing resource consumption and establishing measurable patient outcomes to justify staff use will also be part of the manager's challenges related to health care delivery in the twenty-first century.