Are you a doctor, dentist, pharmacist, or other healthcare professional in Quebec? Your accounting and tax situation is unique. From incorporating your practice and managing a corporation to claiming industry-specific deductions and planning for retirement, a healthcare-specialized accountant makes all the difference. This guide explains why, how to choose one, and how much it costs.
Unlike a typical business owner, healthcare professionals operate within a specific regulatory framework. Your professional association (Medical Association, Dental Association, Pharmaceutical Association) imposes strict rules regarding the structure of your practice, incorporation, and share ownership. A general accountant may not be familiar with these nuances and could cause you to miss out on significant tax savings.
Healthcare professionals face tax challenges that few other sectors encounter:
Since 2007 in Quebec, doctors have been allowed to incorporate. Dentists, pharmacists, optometrists, and chiropractors also have this right. Incorporation as a corporation (SPA) is often the most powerful tax-optimization tool for high-income healthcare professionals.
In practical terms, a doctor who earns $400,000 a year and does not need all of that money to live can leave a significant portion in his or her practice. Instead of being taxed at the maximum marginal rate of 53%, income retained in the SPA is taxed at approximately 26.5% (combined federal-provincial rate on active income from a private corporation). This is a significant tax deferral that allows you to invest and grow your capital more quickly.
An accountant who specializes in your industry can guide you through setting up and effectively managing this structure.
In addition to the professional practice, several doctors and dentists establish a holding company that owns the shares of the professional practice. This two-tier structure offers additional benefits:
Setting up such a structure requires an accountant who is well-versed in the rules specific to healthcare professionals. Anti-tax-avoidance rules, particularly the TOSI (Tax on Split Income), have made income splitting more complex since 2018. Only a specialized CPA can navigate these rules correctly.
In Quebec, several professional associations allow their members to practice as a corporation. Here are the main healthcare professionals who benefit from having a specialized accountant:
Doctors have the most complex tax situation among healthcare professionals. RAMQ income, flat-rate fees, on-call premiums, on-call shifts, clinical research: there are many sources of income. Incorporation is particularly advantageous for specialists whose annual income exceeds $300,000. The Collège des médecins du Québec strictly regulates the practice of medicine as a corporation with specific rules regarding the composition of the shareholder base.
Dentists who own clinics must manage both their professional practice and a full-fledged business: expensive equipment (dental chairs, digital X-ray machines, 3D scanners), employees (hygienists, assistants), and inventory of supplies. The accounting for a dental clinic is more similar to that of an SME than to that of a medical practice. Capitalization allowances (CCA) on equipment are a major tax benefit.
The owner-pharmacist runs a retail business in addition to their professional practice: managing drug inventory, overseeing staff, calculating profit margins on over-the-counter products, and providing pharmaceutical services billed to the RAMQ. Bookkeeping is particularly demanding due to the volume of daily transactions. A specialized accountant knows how to optimize inventory management and maximize eligible deductions.
Optometrists, chiropractors, physical therapists, and psychologists in private practice face common challenges: managing a clinic, mixed billing (RAMQ + private patients + insurers), and the option of incorporating. Even though their incomes are generally lower than those of medical specialists, incorporation becomes advantageous as soon as the professional can save $25,000 or more per year on a regular basis.
Find an accountant who understands the realities of your medical practice. Bankeo will match you for free with the ideal expert from among more than 1,500 partner firms.
Find my accountantThe first step for most healthcare professionals isto incorporate as a corporation. A specialized accountant can assist you with:
One of the most important decisions for a professional in a corporation is determining the optimal split between salary and dividends. This decision directly impacts:
A specialized accountant prepares tax projections each year to adjust this allocation based on your personal needs, your age, and your future plans (such as buying a home, retirement, or children in school).
Accounting for a healthcare practice involves:
Healthcare professionals generally do not have defined-benefit pension plans. As a result, the SPA becomes an essential retirement vehicle. Unlike an RRSP, which must be converted into a RRIF at age 71 (with mandatory withdrawals), the SPA does not require any conversion or mandatory withdrawals. A CPA specializing in taxation will plan your gradual withdrawals to minimize your overall tax burden in retirement.
Rates depend on the complexity of your practice, the number of entities involved (SPA, management company), and the services requested. Here is a guide to indicative rates for 2026:
| Service | Unincorporated professional | SPA only | SPA + management company |
|---|---|---|---|
| Annual bookkeeping | $1,200 - $2,000 | $1,800 - $3,000 | $2,500 - $4,000 |
| Tax returns (Q1 + Q2 + CO-17) | $800–$1,500 | $2,000–$3,500 | $3,500 - $5,500 |
| Annual Tax Planning | $500–$1,000 | $1,000–$2,000 | $1,500 - $3,000 |
| Initial incorporation (accountant + attorney) | N/A | $3,000–$5,000 | $5,000–$8,000 |
| Estimated total annual cost | $2,500 - $4,500 | $4,800 - $8,500 | $7,500 - $12,500 |
Even though accounting fees may seem high, an accountant specializing in the healthcare industry typically generates tax savings of $20,000 to $50,000 per year by optimizing your tax structure. The return on investment is almost immediate. To compare accounting rates in Quebec, check out our comprehensive guide.
A specialized accountant will ensure that you claim all eligible deductions. Here are the main categories:
Professional associations require a certain number of hours of continuing education. These costs are fully tax-deductible:
Not all CPAs are created equal when it comes to accounting for healthcare professionals. Here are the key criteria for making the right choice:
Get ready for that first meeting with our guide to preparing for your meeting with an accountant.
Searching for a healthcare-specialized accountant on your own can take weeks and doesn't guarantee you'll find the right fit. Bankeo simplifies this process:
Whether you're a general practitioner in Montreal, a dentist in Quebec City, or a pharmacist and business owner in the regions, Bankeo serves all of Quebec.
Doctors, dentists, pharmacists: find the perfect accountant for your practice in just a few clicks. It’s free and there’s no obligation.
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Healthcare professionals often make the same mistakes when it comes to accounting and taxes:
The Ordre des CPA du Québec recommends reviewing your tax planning annually, especially if your income has changed by more than 10% or if your family situation has changed. For a self-employed healthcare professional considering incorporation, the ideal time is often the start of a new tax year.
Most professionals regulated by a professional association may form a partnership, including physicians, dentists, pharmacists, optometrists, chiropractors, and psychologists. Each professional association has its own rules governing the practice of medicine in a partnership. Check with your professional association to find out the specific requirements that apply to your practice.
Initial incorporation costs range from $3,000 to $8,000 (accounting and legal fees), depending on whether you choose a SPA on its own or a SPA with a management company. These costs are generally recouped within the first year thanks to tax savings.
Incorporation generally becomes advantageous when you can consistently save $25,000 or more per year. For medical specialists earning $300,000 or more, the benefit is almost always there.
The SPA (public limited company) is the entity that conducts your professional activities and receives your fees. The holding company (holdco) is a separate entity that owns the shares of the SPA and serves to protect accumulated investments, facilitate intergenerational transfers, and provide access to certain tax exemptions.
If a doctor is solely a salaried employee, their accounting needs are simpler. However, the majority of doctors in Quebec have a mixed income (RAMQ + private practice fees), which makes it necessary to hire a specialized accountant.
Deductions that are often overlooked include continuing education and conference expenses (including travel), interest on loans taken out to purchase a stake in a clinic, home office expenses (if applicable), and expenses related to hiring temporary staff.
No, the pharmacist-owner has retail management needs (inventory, profit margins, a large staff) in addition to professional accounting. Their bookkeeping is generally more complex due to the high volume of daily transactions.
Yes, you can switch accountants at any time. It’s best to do so after your annual tax returns have been filed to avoid any transition issues. Your new accountant will request the files from the previous firm.
Absolutely. Bankeo connects healthcare professionals with specialized accountants from its network of over 1,500 partner firms in Quebec—free of charge. You choose how many accountants you’d like to meet.
The most commonly used software programs are QuickBooks and Sage for general accounting, combined with practice management software (EMR) for billing. Your specialized accountant can recommend the best combination for your practice. Check out our guide to accounting software in Quebec for a comprehensive comparison.
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