Job Description: 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
1. 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.
2. Scope of Practice
The physician practises within the full scope permitted by their CPSBC licence class, their certification, and their demonstrated competence, and within the limits of ChangePain's clinical privileging framework. Scope is grouped below as Core, Credential-Dependent, and Out of Scope.
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 clear, 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-guided and landmark-guided joint, bursal, and peritendinous corticosteroid injection — Training log + privileging + facility standards compliance
Viscosupplementation / hyaluronic acid injection — As above
Trigger point and intramuscular stimulation (IMS) / dry needling — Recognized training; CPSBC scope confirmation
Platelet-rich plasma (PRP), prolotherapy, and other regenerative injectates — Training + clinic sign-off + mandatory informed-consent disclosure that these are uninsured, evidence-limited services
Botulinum toxin for myofascial or headache indications — Product-specific training; separate privileging
Aspiration of joints and bursae; fracture and dislocation reduction; casting/splinting — Demonstrated competence
Nail trephination, wound care, minor office procedures — Demonstrated competence
Event, team, or sideline medical coverage on behalf of the clinic — Current ACLS; approved by Medical Director; separate coverage agreement
Virtual care — Compliance with the CPSBC Practice Standard on Virtual Care and clinic telehealth policy
Privileging note: Any procedure not on the physician's approved privileging list must be requested in writing and approved by the Medical Director before first use at ChangePain. New service lines with a billing dimension require Operations sign-off before launch.
2.3 Out of Scope for This Role
- All surgical intervention.
- Neuraxial, epidural, radiofrequency ablation, medial branch blocks, sympathetic blocks, and neuromodulation procedures — these remain within the Interventional Pain / Anesthesiology stream unless the physician holds separate credentials and privileges.
- Longitudinal primary care and comprehensive family practice attachment (patients retain their own primary care provider; ChangePain does not assume most-responsible-provider status for unrelated general medical care).
- Independent medical examinations (IMEs) for a payer where the physician has a treating relationship with the patient — this is a conflict of interest and is not permitted.
- Compounding, dispensing, or selling products or supplements to patients outside approved clinic policy.
3. Non-Clinical Duties
Documentation and records
- Complete, contemporaneous EMR documentation meeting the CPSBC Practice Standard on Medical Records — charts closed within the same business hours of the encounter.
- Consultation letters returned to referring providers within five business days.
- Adherence to PIPA and clinic privacy, retention, and disclosure policy.
Billing and revenue integrity
- Accurate MSP billing consistent with the MSP Payment Schedule and ChangePain's MSP Billing Policy, including correct use of consultation, referral, and telehealth codes.
- Clear separation of insured (MSP) from uninsured services; no billing a patient for a service that is publicly insured.
- Written, signed informed financial consent before any uninsured service is delivered.
- Cooperation with internal billing audits and prompt correction of identified errors.
Quality, teaching, and governance
- Participation in quality improvement, outcome measurement (e.g. PROMs, functional and pain interference measures), and clinical audit.
- Teaching and supervision of fellows, residents, students, and allied health staff in coordination with the Fellowship Director.
- Attendance at clinical rounds, staff meetings, and assigned committees.
- Contribution to clinical pathway and policy development.
- Maintenance of CPD/Mainpro+ or MOC requirements and provision of evidence on request.
Professional conduct
- Adherence to CPSBC practice standards, Canadian Medical Association Code of Ethics, and all ChangePain policies including boundaries, harassment, conflict of interest, and social media.
- Immediate disclosure to the Medical Director of any CPSBC action, CMPA matter, licence condition, or legal proceeding affecting practice.
4. Administrative Responsibilities and Requirements
The SEM Physician is expected to carry a defined share of administrative and program responsibility. This is not incidental to the clinical role — ChangePain operates a multi-department, multi-payer model in which clinical decisions carry direct billing, compliance, and capacity consequences.
4.1 Administrative Duties
Program and pathway administration
- Contribute to the design, documentation, and periodic review of the SEM clinical pathway, including referral acceptance criteria, intake screening, triage rules, and discharge criteria.
- Advise on scope boundaries between the SEM stream and the Interventional Pain, Physiatry, and Allied Health streams so that referrals route correctly on first pass.
- Participate in capacity and access planning: schedule template design, new-patient to follow-up ratio, wait-list management, and no-show/late-cancellation mitigation.
Records, information systems, and privacy
- Maintain proficiency in the clinic EMR, including templates, order sets, outcome-measure capture, and structured data entry required for reporting.
- Comply with, and contribute to, records governance under PIPA and CPSBC standards — access, disclosure, correction, retention, and destruction.
- Report privacy incidents and suspected breaches to the Privacy Officer immediately and in writing.
Financial and billing administration
- Maintain working knowledge of the MSP Payment Schedule provisions applicable to the role and of ChangePain's MSP Billing Policy.
- Submit billing data accurately and on schedule; respond to billing queries, rejections, and audit requests within clinic turnaround targets.
- Provide input to fee-setting for uninsured services and to the annual budget for SEM-related supplies, injectables, and equipment.
- Support the clear separation of insured from uninsured revenue and the documentation trail that separation requires.
Resource and vendor stewardship
- Oversee appropriate use, maintenance logging, and safety checks of assigned clinical equipment (e.g. diagnostic ultrasound).
- Provide clinical input on equipment, consumable, and product selection; disclose in writing any financial or non-financial interest in a vendor, supplier, product, or research sponsor in accordance with the clinic's Conflict of Interest Policy.
- Flag supply, inventory, or equipment-availability issues to Operations before they affect scheduled care.
Policy, quality, and risk
- Contribute to development and revision of clinical policies, SOPs, consent forms, and patient-facing materials within the SEM scope.
- Participate in quality improvement cycles, outcome measurement, and clinical audit; act on audit findings within agreed timelines.
- Complete incident and near-miss reports; participate in root-cause review where requested.
- Support accreditation, licensing, and regulatory inspection readiness.
People and team administration
- Provide clinical direction to, and appropriate delegation of tasks to, nursing, MOA, and allied health staff — while noting that formal supervision, performance management, and discipline of clinic employees remain with the Operations Director and Medical Director.
- Participate in the recruitment, orientation, and clinical onboarding of new SEM and allied health staff, fellows, and residents when requested.
- Maintain a current credentialing file with the clinic: licence, CMPA coverage, certifications, privileging list, CPD records, and immunization status; provide updated documentation proactively before expiry.
Meetings and committees
- Attend clinical rounds, case conferences, and staff meetings as scheduled.
- Serve on at least one standing clinic committee (e.g. Quality & Safety, Clinical Policy, Prescribing Practices) as assigned by the Medical Director.
Administrative time allocation
- ______ hours per week (or ____ of each session) is designated non-clinical administrative time for the above. Administrative expectations outside this allocation will be agreed in advance and, where the engagement is sessional or contracted, compensated in accordance with the Physician Services Agreement.
4.2 Administrative Qualifications and Experience
Required
- Minimum three (3) years of independent clinical practice following completion of certification, of which at least three years must be in an outpatient or ambulatory setting. Fellowship and residency training does not count toward this requirement.
- Minimum three (3) years of documented experience managing a personal patient panel or clinical caseload, including responsibility for scheduling, chart completion, and referral correspondence turnaround.
- Demonstrated proficiency with electronic medical records in a clinical setting (ChangePain's platform, or a comparable EMR with demonstrated ability to transition).
- Demonstrated working knowledge of physician billing in a publicly funded system — MSP experience strongly preferred; equivalent provincial plan experience considered.
- Demonstrated experience preparing third-party documentation and reports (WorkSafeBC, ICBC, private and long-term disability insurers, or equivalent).
- Demonstrated record of complete, timely clinical documentation, verifiable through references.
Preferred
- Prior formal administrative or leadership appointment — clinic lead, program director, department head, medical director, committee chair, or equivalent.
- Experience in a multidisciplinary or multi-department clinic, as distinct from solo or single-discipline practice.
- Experience contributing to clinical policy, SOP, pathway, or protocol development.
- Formal training or credential in quality improvement, patient safety, health administration, or physician leadership (e.g. CMA PLI, QI certificate, MBA/MHA/MPH).
- Experience with clinic accreditation, regulatory inspection, or external audit.
- Experience in budget input, service costing, or new service-line development.
- Experience supervising or teaching learners in a clinical setting.
Verification. Experience requirements will be confirmed through CV review, structured reference checks with prior clinical or administrative supervisors, and CPSBC registration history. Where a candidate's experience is close to but below the three-year threshold, the Medical Director may recommend an exception in writing, subject to a defined mentorship and review plan.
5. Qualifications
Required
- MD or equivalent from a recognized medical school.
- Full practising registration with the College of Physicians and Surgeons of British Columbia (or eligibility, with licensure obtained before start date).
- CCFP, or Royal College certification in Physical Medicine & Rehabilitation, Emergency Medicine, Pediatrics, or Internal Medicine.
- One or both of: CASEM Diploma in Sport & Exercise Medicine (Dip. Sport Med.), or CFPC Certificate of Added Competence in Sport & Exercise Medicine (CCFP-SEM). Royal College Area of Focused Competence in SEM is also accepted.
- Current CMPA membership at a type of work code appropriate to the scope above.
- Current ACLS (or BLS at minimum, with ACLS required if performing event coverage).
- Demonstrated experience in chronic/persistent pain populations.
- Minimum three (3) years of post-certification clinical practice — see Section 4.2 for the full experience and administrative requirements, which form part of the qualification criteria for this role.
Preferred
- Fellowship training in SEM (PGY-3 enhanced skills or equivalent).
- Diagnostic and interventional MSK ultrasound competence.
- Additional training in pain medicine, concussion, or MSK ultrasound.
- Experience with WorkSafeBC, ICBC, and disability insurer processes.
- Teaching appointment or interest in a UBC clinical faculty appointment.
- Additional language capability reflecting the clinic's patient population.
6. Core Competencies
Competency — What it looks like here
Biopsychosocial reasoning — Treats pain as a whole-person problem; does not chase structural findings in isolation
Diagnostic discipline — Orders imaging and procedures because they change management, not to reassure
Team practice — Shares formulation, defers appropriately, communicates decisions rather than announcing them
Communication — Explains chronic pain in plain language; delivers difficult messages (no cure, taper needed, no further imaging) without abandoning the patient
De-prescribing skill — Can taper opioids and sedatives while maintaining the therapeutic relationship
Documentation rigour — Charts to a standard that withstands CPSBC, MSP audit, and medico-legal review
Boundary management — Handles demanding requests for opioids, notes, and uninsured services consistently and on policy
7. Working Conditions
- Outpatient ambulatory clinic; standard hours 08:00 to 17:00, Five days per week; occasional evening or weekend sessions by mutual agreement.
- Prolonged standing, patient positioning and handling, and use of ultrasound equipment.
- Regular exposure to patients in distress; exposure to conflict and to complex disability and medico-legal dynamics.
- Mixed in-person and virtual care delivery.
8. Performance Indicators
Reviewed at 3 months, 12 months, and annually thereafter:
1. Chart closure and consult-letter turnaround within policy targets.
2. Billing accuracy — audit exception rate below the clinic threshold.
3. Patient-reported outcomes: functional improvement and pain interference change across a defined episode of care.
4. Opioid/sedative prescribing practices consistent with the CPSBC standard, verified on internal review.
5. Interdisciplinary engagement — case conference participation and referral appropriateness.
6. Patient experience feedback and complaint volume.
7. Teaching and QI contribution.
