Hello Brent,
PBR policy based routing is the tool you need to go beyond destination based routing.
on the lan interface you apply
ip policy route-map mypbr
route-map mypbr permit 10
match ip address voip
set ip next hop microwave:nexthop
have the preferred default route via DSL and access-list voip is a named extended ip acl that defines voip bearer channels (RTP and RTCP) and signalling flows (SIP or H.323 or SCCP ...)
Hope to help
Giuseppe