Sport & Exercise Medicine PhysicianChangepain Medical & Allied Health Clinic, Burnaby BC

Medical Services, MSK & Rehabilitation Stream. Reports to the Medical Director (clinical) and Operations Director (administrative). Works with Interventional Pain, Physiatry, Psychology, Physiotherapy, Kinesiology, OT, Nursing, and Clinical Admin. Independent contractor (Physician Services Agreement), full time. MSP fee-for-service via clinic billing, plus administrative compensation. Effective August 1, 2026.

- Position SummaryNon-operative musculoskeletal (MSK) and exercise-based care for patients with persistent, complex pain, at the front end of Changepain's interdisciplinary model: accurate diagnosis, de-escalation of unnecessary imaging and intervention, functional restoration through graded activity, and triage into or away from interventional, psychological, and rehabilitative pathways.

This is not a sideline sports practice transplanted into a pain clinic. The population is predominantly chronic (>3 months), frequently deconditioned, often carrying central sensitization, mood comorbidity, medication complexity, disability claims, and prior failed treatment. The role requires biopsychosocial, function-first medicine practised as a team peer.
- Scope of PracticeBounded by CPSBC licence class, certification, demonstrated competence, and Changepain's privileging framework.

Assessment. MSK history and exam of spine, upper limb, lower limb, and pelvis. Differential diagnosis across mechanical, inflammatory, neuropathic, nociplastic, referred/visceral, and systemic causes. Red flag screening (malignancy, infection, fracture, cauda equina, inflammatory arthropathy, vascular) with urgent escalation.

Yellow flag screening (fear-avoidance, catastrophizing, low self-efficacy, sleep disruption, mood disorder) with referral to psychology. Central sensitization and nociplastic assessment, with plain-language pain neurophysiology education. Concussion and post-concussion syndrome: post-traumatic headache, cervicogenic contribution, vestibulo-ocular dysfunction, return-to-learn and return-to-work staging.

RED-S, disordered eating, bone stress injury, and overtraining where they intersect with chronic pain.

Investigation. Ordering and interpreting radiography, ultrasound, CT, MRI, bone scan, DEXA, EMG/NCS, and labs. Imaging stewardship: avoid low-value imaging; counsel explicitly on incidental and age-normal findings to prevent iatrogenic distress.

Management. Graded exercise and loading prescription (strength, mobility, aerobic conditioning, tendon loading, motor control, pacing). Activity modification, ergonomic and biomechanical advice, load management, flare-up planning. Bracing, orthoses, taping, gait aids, footwear. Sleep, nutrition, weight, smoking, and alcohol counselling as related to pain and recovery. Manual and adjunct therapy referral with measurable goals and review points.

Pharmacological. Non-opioid analgesia, NSAIDs (with GI/renal/CV risk assessment), topicals, neuropathic agents, muscle relaxants, sleep agents, and adjuncts. Controlled drugs strictly per the CPSBC Practice Standard on Secure Prescribing of Drugs with Potential for Misuse/Diversion: PharmaNet review each relevant encounter, treatment agreements, risk stratification, urine drug testing where indicated, and documented rationale for continuation, rotation, or taper.



Opioid tapering and deprescribing with the team.

Recognition of opioid and substance use disorder with referral; opioid agonist therapy not expected unless separately credentialed.

Interdisciplinary. Formulate and document interdisciplinary care plans; attend case conferences and rounds. Triage to interventional pain, physiatry, rheumatology, neurology, orthopaedics, or surgery, and receive referrals back. Timely consult letters to referring physicians, NPs, and specialists.

Disability, functional capacity, and return-to-work management (WorkSafeBC, ICBC, private insurer, LTD), including forms and reporting to treating-physician standard. Medico-legal reporting and, where agreed in advance, expert or treating-physician testimony.

Credential-dependent. Only with documented training, privileging, and current competence: point-of-care MSK ultrasound; guided and landmark corticosteroid injection of joint, bursa, and peritendinous tissue; viscosupplementation; trigger point and IMS/dry needling; botulinum toxin for myofascial or headache indications; PRP, prolotherapy, and other regenerative injectates, with mandatory consent disclosure that these are uninsured and evidence-limited; joint and bursal aspiration, fracture and dislocation reduction, casting/splinting, nail trephination, wound care, and minor office procedures; event or sideline coverage (ACLS, Medical Director approval, coverage agreement); virtual care per the CPSBC Virtual Care standard. Anything outside the approved privileging list requires written request and Medical Director approval before first use; new service lines with a billing dimension need Operations sign-off.

Out of scope. All surgical intervention. Neuraxial, epidural, radiofrequency ablation, medial branch blocks, sympathetic blocks, and neuromodulation, which stay with Interventional Pain absent separate credentials.

Longitudinal primary care: patients keep their own provider and Changepain does not assume most-responsible-provider status. Independent medical examinations for a payer where a treating relationship exists (conflict of interest). Compounding, dispensing, or selling products or supplements outside clinic policy.

- Administrative ResponsibilitiesAdministrative responsibility is not incidental: Changepain runs a multi-department, multi-payer model where clinical decisions carry direct billing, compliance, and capacity consequences. The physician is accountable for EMR documentation to the CPSBC Practice Standard on Medical Records, charts closed the same business day, consult letters within five business days; records governance under PIPA, with privacy incidents and suspected breaches reported to the Privacy Officer immediately and in writing; accurate MSP billing with documented insured/uninsured separation, no patient billing for publicly insured services, and signed financial consent before uninsured services; design and review of the SEM pathway, covering referral acceptance, triage,



discharge criteria, scope boundaries with adjacent streams, and input to scheduling and wait-list management; clinical policies, SOPs, consent forms, QI cycles, PROM capture, audit, incident reporting, and accreditation readiness; stewardship of assigned equipment and written disclosure of vendor or sponsor interests; supervision of learners and clinical direction of nursing and MOA staff, with formal supervision and discipline remaining with Operations and the Medical Director; and rounds, case conferences, a standing committee, and a current credentialing file. Full duty detail is scheduled to the Physician Services Agreement.
- QualificationsRequired, clinical. MD or equivalent from a recognized medical school. Full practising CPSBC registration, or eligibility with licensure before start date. CCFP, or Royal College certification in Physical Medicine & Rehabilitation, Emergency Medicine, Pediatrics, or Internal Medicine. CASEM Diploma in Sport & Exercise Medicine or CFPC Certificate of Added Competence in SEM; Royal College AFC in SEM also accepted. Current CMPA membership at a work code appropriate to the scope above. Current ACLS, or BLS minimum with ACLS required for event coverage. Demonstrated experience in chronic pain populations.

Required, experience. Minimum three years of independent outpatient practice after certification, managing a personal patient panel including scheduling, chart completion, and referral turnaround; residency and fellowship do not count. EMR proficiency (Changepain's platform, or comparable with demonstrated ability to transition). Working knowledge of billing in a publicly funded system, MSP strongly preferred.

Experience preparing third-party documentation (WorkSafeBC, ICBC, private and long-term disability insurers). Record of complete, timely documentation, verifiable through references.

Preferred. SEM fellowship; MSK ultrasound competence; further training in pain medicine or concussion; additional language capability; prior leadership appointment; multidisciplinary rather than solo practice; policy or pathway development; formal QI, health administration, or leadership training; accreditation or audit experience; teaching learners.

- Core Competencies
- Biopsychosocial reasoning — treats pain as a whole-person problem, not a structure to chase.
- Diagnostic discipline — images and injects to change management, not to reassure.
- Communication — explains chronic pain plainly; delivers hard messages (no cure, taper, no further imaging) without abandoning the patient.
- Boundaries — handles opioid, note, and uninsured-service requests consistently and on policy.

6. Working Conditions and ReviewOutpatient clinic, 08:00 to 17:00, five days a week, with occasional evening or weekend sessions by mutual agreement. Prolonged standing, patient positioning and handling, ultrasound use. Regular exposure to patients in distress, to conflict, and to complex disability and medico-legal dynamics. Mixed in-person and virtual care.
1. Performance is reviewed at 3 months, 12 months, and annually against documentation turnaround, billing audit exception rate, patient-reported function and pain interference change, prescribing consistency with the CPSBC standard, interdisciplinary engagement, patient experience, and teaching and QI contribution.

📌 Sport & Exercise Medicine Physician (Burnaby)
🏢 Changepain Medical u0026 Allied Health Clinic
📍 Burnaby