Abstract
BACKGROUND: In salaried primary care systems, internally generated demand, such as physician-initiated recalls, can limit timely access for other patients. OBJECTIVE: To evaluate whether reserving protected time for unscheduled physician phone calls decreases recall appointment volume. DESIGN: A quality improvement intervention with a before-and-after analysis. SETTING: A salaried family medicine clinic in northern Saskatchewan. PARTICIPANTS: All clinic patients recalled for visits between October 2024 and February 2025 (1005 recalls). INTERVENTION: A daily 30-min block was reserved in each physician's morning schedule for discretionary phone-based follow-up. MAIN MEASURES: Total number of recalls, recall reasons, and patient demographics before and after implementation. KEY RESULTS: Recall appointments dropped by 28.7%, particularly those related to bloodwork, imaging, and specialist communication. However, the time invested in protected communication slots exceeded the time saved from reduced recalls, suggesting a shift in physician workload rather than an overall reduction. CONCLUSION: Allocating protected communication time may support more flexible follow-up and improve task completion efficiency, but does not appear to meaningfully expand physician appointment access.