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I use Skype daily on a professional basis. I work on both sides of the Atlantic at different times of the year and I subscribe to the Skype-In service.
Basically I can have one or more local phone numbers, like one 214-number for Dallas, one 917-number for New York, and one number in London and one in Sweden. So my local contacts always have a local, or at least national number to reach me at and it connects to my computer or my cell. I probably handle 20-30 hours of phone conversations over Skype monthly and I'm satisfied. There is a small lag compared to normal landlines, but all the benefits of being able to pick up when I'm at a clients office well over shadows any such small downsides. I have an expense account on each project I'm on and wouldn't use Skype if it didn't perform well.
Have a look at Google Voice when at it, it works very much the same but with new cool features like getting a transcript of recorded voice mails, being able to filter calls, and decide which phone to forward to depending on time of day and also depending on who's calling my number. A very nice feature and highly recommendable!
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