New York: What Is That Two-Headed Phone?

Harold Schiffman hfsclpp at
Thu May 14 16:57:40 UTC 2009

What Is That Two-Headed Phone?
By Jennifer 8. Lee

Jennifer 8. Lee/The New York Times

Dual-handset phones will become commonplace at the city’s largest
pharmacies as part of a government agreement.Dual-handset phones may
be a common sight at the city’s pharmacies, as drugstore chains roll
out real-time interpretation services under agreements with the New
York State attorney general’s office reached over the last year.

The phones seem somewhat unnatural — vaguely reminiscent of two-headed
monsters in a world where phones in general have been getting sleeker,
more portable and increasingly sophisticated. These corded phones are
throwback clunkers, like a Cadillac from the 1980s. But they are a
necessary reality in a polyglot city in which nearly half of the
residents speak a language other than English at home.

At Rite Aid, which is pilot testing the dual-handset phones in 25
stores in Manhattan and the Bronx, the interpretation services are
provided by Language Line, which is also used by the Police
Department. The phone provided by Language Line has an “Interpreter”
speed-dial button (remember speed-dial?), which connects the
pharmacist and the customer with an automated voicemail system. (”For
Spanish, press 1. For all other languages, press 2.”) That leads them
to interpreters who sit in 18 time zones around the world. The service
offers 175 languages.

All 225 Rite-Aid stores in the city will have access to interpretation
services, though in most cases without the dual-handset phone. Before
the phone system, translation was more haphazard. “Mostly we relied on
our own associates,” said Scott Jacobson, the director of pharmacy for
Rite Aid.

The ad-hoc approach was criticized by nonprofit groups, which
complained that non-native English speakers were running into language
barriers in pharmacies.

“Our clients were having trouble getting their medication,” said Nisha
Agarwal, director for health justice with New York Lawyers for the
Public Interest, which first filed a complaint with the civil rights
division of the attorney general’s office in 2007. Last August, the
group released a report titled “Bad Medicine” [pdf], which found
dismissive pharmacists and patients who did not take medicine because
they were afraid they would get the instructions wrong. “The stories
we hear are horrific from clients,” Ms. Agarwal said.

The groups argued that under New York State law, pharmacists are
personally required to provide patients spoken and written information
about the dosage, purpose and side effects of prescription drugs.
Pharmacies are also prohibited under both state and federal law from
discriminating against non-English speakers. Federal law prohibits
pharmacies from discriminating if they receive Medicaid and Medicare
(which essentially all of them do).

The conclusion was that even non-native speakers would have to receive
spoken and written instructions.

For years, health care providers have tried to find creative solutions
to language barriers (including one doctor who called a local
Vietnamese restaurant to find a translator). In September 2006, the
state’s Department of Health set out detailed regulations on hospitals
and language policy. Among them was a prohibition against using
children as interpreters, because sometimes they were not competent
with medical terminology and because domestic violence episodes
sometimes created awkward situations for the children.

Hospitals are now required to provide interpreter services within 10
minutes in the emergency room and within 20 minutes in any other part
of the hospital.

In addition, other number of advocacy groups have won the right to an
interpreter in other contexts, including administrative courts.

The pharmacy chains that have agreed to introduce the phones include
Duane Reade, Food Emporium, Costco and Target.

The agreement also requires chains to provide written information
about the medication they sell in at least five of the main foreign
languages spoken in New York: Spanish, Chinese, Italian, Russian and
French. Rite Aid said it was already providing multilingual services,
so the discussion with the attorney general’s office was relatively
amicable. “It became mainly a technicality on our part,” Mr. Jacobson

With the agreement, New York became the first state to have such a
comprehensive policy. Advocacy groups are also lobbying for a city law
that would apply to all pharmacy chains with five or more stores, not
just the large chains that have reached an agreement. The City Council
health committee held a hearing on the matter last week. “We’re
hopeful that this is something that can move,” Ms. Agarwal said.
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