Anecdotal evidence and a limited body of research suggests that telephone interactions between health care consumers and health professionals form an important part of unscheduled health care provision. However, very little is known about these interactions, particularly in the rural context. In rural Australia, there is a need to explore a range of models of service delivery. Telephone-based unscheduled care is one area that demands consideration. By defining unscheduled health care and delineating telephone-based unscheduled health care from other telehealth services, the concepts of formal and informal telephone-based unscheduled health care provision are explored. This article raises previously unasked questions about the role of telephone-based unscheduled health care in the rural context. As a dimension of health care that is poorly understood, the need for further conceptualisation, research and policy development in this area is highlighted.