Thriving in Telepractice

by Melissa Jakubowitz, MA, CCC-SLP, ASHA Fellow

When I started my speech-language pathology career many years ago, my first job was in public schools. I had plans to stay in the schools for my entire career, but that didn’t happen! After a few years, I found the paperwork taking too much of my time (which is funny now, since the paperwork has only increased since then). So, I left the schools to explore working with adults. That lasted about 6 months before I decided to open a private practice. Both my practice and I thrived. It was wonderful to be my own boss. After 20 years in an in-person private practice, I needed a change and ended up in telepractice—first working for a telepractice start-up and then leaving to open my own telepractice company.

If you’re ready to make the leap to telepractice, consider some of the following differences between telepractice versus in-person services:

Telepractice	In-Person
Colleagues are distant from you and not as easy to get ahold of. It can get lonely!	Colleagues are available with whom you can share ideas and information.
There’s no commute if you work from home.	Commute can add time to your already long day.
Telepractice tends to involve smaller groups and caseloads.	Caseloads may be high, depending on district and state caseload limits.
As a telepractitioner, you may have more missed sessions due to tech issues or no-shows.	It’s easier to track down students who forget to come to therapy.
You can set your own schedule.	Your schedule is set—you are required to be at your school site for specific times.
Sitting all day can be hard on your body.	You have the ability to get up and move during the day to pick up students in their classes.
You often need to purchase equipment and better Internet services, tests, materials, etc.	Schools often have budgets for materials and equipment.
It is difficult to understand the school culture from a distance.	Being on-site, you have firsthand experience and can come to understand the school culture much more quickly.
You may need to get licensed in more than one state.	You need only one license or teaching credential.

If you’re the type of person who works independently and doesn’t mind not having immediate access to other adults in your work setting, then telepractice may be for you. Make sure you talk with not only current but also former telepractitioners.

If you decide that telepractice is a setting for you, asking the right questions of a potentialemployer will help you decide which company is best for you. Here are some questions to ask a potential employer:

Do they hire you as an independent contractor or employee? (Understand the difference between these two!)
Are your hours guaranteed? If so, get this in writing.
Do they have a policies and procedure manual that specifically covers HIPAA, confidentiality, security, and so forth? If they have one, ask to see it.
Do they pay for you to get licensed in another state? These fees can add up if you need more than one license. You also need to track renewal dates and continuing education requirements for each state.
Do they provide you with a videoconferencing platform, therapy materials, and tests?
Do they offer training on their platform?
If you are new to telepractice, is there a supervisor or mentor available who will support you while you get used to teletherapy?
Will you need to obtain malpractice insurance? If the answer is no, ask how the company’s insurance will cover you.

Get more tips from my Career Portal Live Instagram interview.

For more information about telepractice, visit the ASHA Telepractice Resources During COVID-19 and ASHA Practice Portal for Telepractice

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