Disadvantages to telehealth as a business model

In last month’s article, “Benefits of telehealth as a business model,” I shared the cost advantages to using telehealth to conduct psychotherapy instead of meeting in an office. I mentioned that it is important to include in your assessment of business “costs” how any business decision may tax your energy, time, work-life balance, and morale.

While telehealth is more cost-effective than investing in an office space, it is not the answer for every business owner. Telehealth has some significant drawbacks to consider when developing your business.

One disadvantage of telehealth is that your ability to read visual cues is limited. As psychologists, you gather data on your client’s wellness not only with what they share, but also by observing their behaviors and movements.

When meeting over a computer screen, you can no longer notice changes in bodily health, weight gain or loss, injuries, or other issues with physical mobility. Data collection through observation becomes significantly limited and additionally, an extra barrier to intimacy is erected as you both sit behind a screen. While in some emotionally heightened sessions, having this barrier may lend itself as helpful to your emotional boundaries, both clients and clinicians can feel a loss of personal connection with telehealth.

Another drawback to telehealth is that you lose full control of the therapeutic space. Depending on where your client chooses to call in from, the possibility of unexpected distractions and disruptions is heightened. With children at home, others interrupting, or unexpected visitors at the door, your client’s attention may be divided when calling in from home.

You are no longer able to create a warm, safe, or comfortable physical space to which your clients can retreat. Some clients need to be away from their home environment to feel safe to speak honestly and fully. Calling in from home can limit their self-expression.

For the clinician, working from home can offer you more time for your daily life maintenance and self-care routines, yet some practitioners feel more taxed with regular household duties that were once divided equally amongst household members.

Family members can easily assume that it is easier for you to oversee household operations and may leave extra responsibilities on your plate figuring that it will not be difficult for you to fit an extra task into your day. Many work-from-home practitioners need to set up strong boundaries for themselves and remind their household members that even though they are home, their work time still needs to be respected as such.

Additionally, working from home may require you to be creative with making clear boundaries between your work-time and home-life to maintain a healthy distinction.

Lastly, one of the most frustrating disadvantages of telehealth is internet connectivity issues and technical problems. There is nothing worse than being in the throes of an important moment in a session only to have one person’s internet freeze or drop the call.

I personally have had sessions where both myself and the client had to log back onto our telehealth platform several times throughout the hour because of significant internet issues.

I have also experienced less tech-savvy clients struggling to work out audio issues and my ability to help them is severely limited. This is not only frustrating for all parties but it can greatly impact the therapeutic work and your ability to provide effective support or a therapeutic intervention.

In conclusion, telehealth as a business model for private practice offers many advantages – primarily a low-cost way to start your business. Yet many will readily acknowledge the personal connection that is lost when moving to an online platform. For some business owners, a mix of in-office and online clients allows them to find their perfect balance and create their business to address all their wants and needs.