Disadvantages
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Less interoperable between technologies (overall) than conventional telecom
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More varied in quality than traditional telecom
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Sound quality
 
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Reliability issues
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Requires electrical power and Internet to be up
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Security issues sometimes arise
 
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Electrical power required, unlike for PSTN phone service (battery back-up now being supplied by some).
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Access to 9-1-1 may be limited (depends on the company)