I'm glad to see that ScamBuster has posted here.
The easiest solution to the scams while retaining the service is registration. For pagers and the like, this is simple. Whatever provider you're using would have it set up when you get it. For general IP relay, it would be slightly more complicated, but still easy. You just sign up with an email address.
This will on its own remove the majority of the prank callers from the pool, simply by losing a small measure of anonymity. It will slow the scammers down, most definitely.
From what I've seen, the primary movement preventing registration appears to be from the deaf community, over fears that it is a step towards making the service a pay service. Really, this is unfounded. More than enough money is going to be going into this for as long as it is around, and reducing the number of prank/scam calls will only make it more efficient.
That, however, is all in the future. For now, I will live with my one confidentiality break, which is warning parties that they are being scammed. One man who had been completely taken in by the scammer called me a "true gentleman." I've never felt so warm inside in my life. The idea that I can simultaneously assist with helping the deaf community communicate and prevent scammers from succeeding is what's keeping me in this job.