Tuesday, September 4, 2007

Relay Calls

It was the Tuesday after a holiday, so the craziness came in bunches today. Hence, this is my second post.

Have any of you pharmacy professionals out there had the pleasure of receiving a relay call? For those that don't know, a relay call allows deaf people to communicate by telephone. They place a call to a relay operator, and type him what they want to say to us. The relay operator, reads the deaf person's words to us, and then relays what we say back to the deaf person by typing it.

I realize that this is an important and necessary service that allows deaf people to make telephone calls. However, it is the most frustrating form of communication. Every sentence takes forever because someone has to type it. The conversation can never have any flow. You can't interrupt the other in mid sentence, so even if they just completely misunderstood what you told them, you have to wait the 2 minutes to get their response.

Pharmacy-related conversations are also very difficult to relay. For one, relay operators don't know drug names. Therefore, they constantly have to pause to ask you how to spell the name of the drug. Plus, it's just really awkward talking to one person, but having to address someone else entirely. I keep saying things like "tell her the insurance won't cover it for another 2 days," instead of addressing her directly.

Anyway... we have 2 customers we receive relay calls from, and unfortunately, they're two of the biggest pains in the ass we have. One of them is always asking for early refills...ON EVERYTHING! In the past 3 months, she's gone from restoril, to vicodin, and now she's on Talwin. Her MO is that she stays with a doctor until he realizes she perfectly fits the criteria of drug-seeking behavior, then she moves on to the next doctor who writes her something else.

I would call her a one of those controlled substance addicts, except for one thing..... She does thes same thing with all her meds!!! She asks for her Naproxen prescription as if the stuff is heroine. She brought in a 30 day supply of Naprosyn 500mg, and then the next day, she brought us another script for Anaprox DS (which is naproxen 550mg). After explaining to her that they'll practically the same thing, she wanted to know how long it was unil I could fill the Anaprox for her.

Another time, she showed up in the afternoon looking to pick up her naproxen script. It showed it was done in the computer, but we couldn't find it in the bin. We spent 5 minutes tearing the place apart looking it. Just when I was ready to just fill the thing again, I decided to see if someone had picked it up (maybe it was given to the wrong person by accident). Guess what? She had picked the script up 5 hours earlier. She signed for it herself. When I asked her about this, she said she knew she picked it up, but wanted to know when it could be filled again. And that's fucking Naproxen. Nobody has ever got high off naproxen. If you take too much of that stuff, the only thing you get is a bad stomach ache and maybe an ulcer.

Today was one those Naproxen days. She called 6 times via relay looking for her naproxen script that the doctor was supposed to have called in. Meanwhile, 30 minutes after each call, her doctor's office would leave a prescription for her on our voice mail for Talwin. Everytime she called, I kept telling her that I think her doctor's office is confused because they keep calling in the same prescription for Talwin over and over again saying that the patient called and told them the pharmacy never got the prescription.

At the end of the day, they never did call in her naproxen, which would have been roughly 15 days too early anyway. I think altogether, her 6 relay calls probably took up 45 minutes of my time... on a Tuesday... after a holiday.... when we filled over 600 prescriptions.

Word of warning: Relay operators are required by law to type everything you say during a relay call. I didn't realize this until about a month ago when I started to say something, changed my mind, and asked the relay operator to tell her something else intead. The relay operator told me she had to type whatever I said. Therefore, if you get a relay call and think that you can make a smart ass or, in any way, derogatory remark to the relay caller about the person on the other end, just know that the operator is technically required to type what you say. Whether he does or not depends on how strictly this particularly operator adheres to the law. In any case, better safe than sorry. If you must make a comment about the caller, wait until you hang up the phone before doing so.


Eric, AKA The Pragmatic Caregiver said...

As a former CA (Communications Assistant, AKA, Relay Operator, AKA eavesdropper on the conversations of thousands), please know that pharmacy calls aren't even bad enough to approach the least-malevolent circle of Hades. There is nothing like being a gay man doing Relay to a gynecologist for a HOH woman experiencing florid symptoms of BV.

I'm surprised I can't find an FAQ for people receiving Relay calls that can make it easier to communicate using a CA. But I'll take a stab at a couple of ideas.

1) Treat it like using instant messenger. Keep thoughts simple and sound-bitey.

2) Because the CA has to type the background noises (like overhead pages, phones ringing, other voices, etc), you can totally improve the call flow by taking relay calls in a private environment. I know this is rarely possible in pharmacy, but it does help.

3) Newer equipment *CAN* interrupt - if someone's using IP relay, the CA can interrupt a response. Use this with caution - it's just as rude as with a voice caller, but it's worth asking the CA during the "setup" if interrupt is available.

4) Offer the opportunity to fax a request over - many users are willing to fax over questions for a written reply.

It *is* a hassle. I had a period where I couldn't speak (irony!) and found myself using Relay and text-to-speech software for about eight weeks, and I can't tell you how hellish it was to get my calls dealt with appropriately.

If you're a reasonably proficient typist, you *might* consider getting a TTY device or PCTTY software for a PC in your pharmacy that can have an analog line hooked to it. It's not very expensive and it's dramatically better than using TRS Relay.


Emily said...

At my old pharmacy, we had one customer who was hearing impaired (not completely deaf) and would use the relay phone service. It is a hassle for sure. It was strange to use. Luckily, though, this customer was a very organized person, always kept track of her refills, etc, so we never had the run-around you seem to experience!

Anonymous said...

You should all be aware also that Internet Protocol Deaf Services are not tracable. We have has several calls via internet phone that as for 300 bottle of Centrum to be sent to Africa, Iran, etc. They want to give a credit card # and have FedEx pick it up. Needless to say, the cards are no good. A few pharmacies have fallen for this. Therefore, we no longer take these internet calls. If our patients need us they can use TTY