In 2012, she established the Crisfield Clinic, a private family practice, to provide care to the rural, underserved community of Crisfield, MD. She is a board member of the Maryland Rural Health Commission, a legislative committee member for the Maryland Rural Health Association and past president of the Nurse Practitioner Association of Maryland. Dr. Palakanis has served as a featured speaker at State and National programs on issues related to rural health care delivery and telemedicine.