Sport & Exercise Medicine Physician

ChangePain Medical & Allied Health Clinic — Burnaby, BC

Position title: Sport & Exercise Medicine (SEM) Physician

Department: Medical Services — Musculoskeletal & Rehabilitation Stream

Reports to: Medical Director (clinical/professional); Operations Director (administrative/scheduling)

Works with: Anesthesiology & Interventional Pain, Physiatry, Psychology/Counselling, Physiotherapy, Kinesiology, Occupational Therapy, Nursing, Pharmacy, Clinical Admin

Status: Independent contractor (Physician Services Agreement)

FTE / sessions: Full time

Compensation model: MSP fee-for-service via clinic billing. Administrative compensation

Effective date: August 1st, 2026

Version / review cycle: v1.0 — reviewed annually by Medical Director & Operations Manager

Position Summary

The Sport & Exercise Medicine Physician provides non-operative musculoskeletal (MSK) and exercise-based medical care to patients living with persistent and complex pain. The role sits at the front end of ChangePain's interdisciplinary model: accurate MSK diagnosis, de-escalation of unnecessary imaging and intervention, restoration of function through graded activity, and appropriate triage into or away from interventional, psychological, and rehabilitative pathways.

This is not a sideline sports practice transplanted into a pain clinic. The patient population is predominantly chronic (>3 months), frequently deconditioned, often carrying central sensitization, mood comorbidity, medication complexity, disability claims, and prior failed treatment. The physician is expected to practise biopsychosocial, function-first medicine and to work as a peer within a team rather than as an isolated consultant.

Scope of Practice

2.1 Core Clinical Scope (expected of all SEM physicians in this role)

Assessment and diagnosis

- Comprehensive MSK history and physical examination of the spine, upper limb, lower limb, and pelvis, including regional and special testing.
- Differential diagnosis across mechanical, inflammatory, neuropathic, nociplastic, referred/visceral,



and systemic causes of pain.
- Screening for red flags (malignancy, infection, fracture, cauda equina, inflammatory arthropathy, vascular pathology) and appropriate urgent escalation.
- Screening for yellow flags — fear-avoidance, catastrophizing, low self-efficacy, sleep disruption, mood disorder, trauma history — and referral into the psychology/counselling stream.
- Assessment of central sensitization and nociplastic pain features; explanation of pain neurophysiology to patients in plain language.
- Assessment of concussion and post-concussion syndrome, including persistent post-traumatic headache, cervicogenic contribution, vestibulo-ocular dysfunction, and return-to-learn/return-to-work staging.
- Recognition and management of the Relative Energy Deficiency in Sport (RED-S) spectrum, disordered eating, bone stress injury, and overtraining presentations where they intersect with chronic pain.

Investigation

- Ordering and interpreting plain radiography, ultrasound, CT, MRI, bone scan, DEXA, EMG/NCS, and relevant laboratory investigation.
- Applying evidence-based imaging stewardship: avoiding low-value imaging, and explicitly counselling patients on incidental and age-normal findings to prevent iatrogenic distress.

Non-operative management

- Individualized, graded exercise and loading prescription (strength, mobility, aerobic conditioning, tendon loading, motor control, pacing).
- Activity modification, ergonomic and biomechanical advice, load management, and flare-up planning.
- Bracing, orthoses, taping, gait aids, and footwear guidance.
- Sleep, nutrition, weight, smoking, and alcohol counselling as they relate to pain and recovery.




- Manual and adjunct therapy referral with explicit, measurable goals and defined review points.

Pharmacological management

- Prescribing and monitoring non-opioid analgesia, NSAIDs (with GI/renal/CV risk assessment), topicals, neuropathic agents, muscle relaxants, sleep agents, and adjuncts.
- Managing controlled drugs and substances strictly in accordance with the CPSBC Practice Standard on Safe Prescribing of Drugs with Potential for Misuse/Diversion, including PharmaNet review at every relevant encounter, treatment agreements, risk stratification, urine drug testing where indicated, and documented rationale for continuation, rotation, or taper.
- Opioid tapering and deprescribing in collaboration with the interdisciplinary team.
- Recognition of opioid use disorder and substance use disorder, with appropriate referral; the physician is not expected to provide opioid agonist therapy unless separately credentialed.

Interdisciplinary and system responsibilities

- Formulating and documenting an interdisciplinary care plan; participating in case conferences and rounds.
- Triaging patients to interventional pain, physiatry, rheumatology, neurology, orthopaedics, or surgery, and receiving referrals back.
- Communicating with referring family physicians, nurse practitioners, and specialists via timely consultation letters.
- Disability, functional capacity, and return-to-work management, including WorkSafeBC, ICBC, private insurer, and long-term disability files; completion of associated forms and independent reporting to the standard expected of a treating physician.
- Medico-legal reporting and, where agreed in advance, expert or treating-physician testimony.

2.2 Credential-Dependent Scope (permitted only with documented training, privileging, and current competence)

Procedure / activity — Prerequisite

- Diagnostic point-of-care MSK ultrasound — Documented POCUS training (e.g. CASEM/CPoCUS MSK stream) + clinic privileging
- Ultrasound

📌 Sport & Exercise Medicine Physician (Vancouver)
🏢 CHANGEpain Clinic
📍 Vancouver