Are you a doctor, dentist, pharmacist or other health professional in Quebec? Your accounting and tax reality is unique. Between incorporating your practice, managing a corporation, deductions specific to your field and planning for your retirement, an accountant specializing in health care makes all the difference. This guide explains why, how to choose it, and how much it costs.
Unlike a traditional entrepreneur, a health professional operates within a specific regulatory framework. Your professional order (College of Physicians, Order of Dentists, Order of Pharmacists) imposes strict rules on the structure of your practice, incorporation and ownership of shares. A general accountant may not be familiar with these particularities and may cause you to miss out on significant tax savings.
Healthcare professionals face tax challenges that few other sectors face:
Since 2007 in Quebec, physicians have had the right to incorporate. Dentists, pharmacists, optometrists and chiropractors also benefit from this right. Incorporation into a business corporation (SPA) is often the most powerful tax optimization tool for a high-income health professional.
In concrete terms, a doctor who earns $400,000 a year and who does not need all that money to live can leave a significant part of his or her company. Instead of being taxed at the maximum marginal rate of 53%, income retained in the corporation is taxed at approximately 26.5% (the combined federal-provincial rate on the active income of a private corporation). It's a major tax deferral that allows you to invest and grow your capital faster.
An accountant specialized in your industry will be able to guide you in the implementation and optimal management of this structure.
In addition to the professional SPA, many doctors and dentists create a management company (holdco) that holds the shares of the professional company. This two-tier structure offers additional benefits:
Setting up such a structure requires an accountant who is familiar with the rules specific to health professionals. Anti-tax avoidance rules, including 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 orders allow their members to practice within a partnership or joint-stock company. Here are the main health professionals who benefit from a specialized accountant:
Physicians have the most complex taxation among health professionals. RAMQ income, block fees, emergency pay, on-call duty, clinical research: there are many sources of income. Incorporation is particularly beneficial for specialists with an annual income of more than $300,000. The Collège des médecins du Québec strictly regulates the practice of the company with specific rules on the composition of the shareholding.
Dentists who own a clinic have to manage both their professional practice and a real business: expensive equipment (dental chair, digital X-ray, 3D scanner), employees (hygienists, assistants), inventory of materials. The accounting of a dental clinic is closer to that of an SME than to a doctor's practice. Capital cost allowances (CCA) on equipment are a major tax lever.
The pharmacist-owner manages a retail business in addition to his professional practice: medication inventory, personnel management, margins on over-the-counter products, 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 allowable deductions.
Optometrists, chiropractors, physiotherapists and psychologists in private practice share common challenges: managing a clinic, joint billing (RAMQ + private patients + insurers), and the possibility of incorporation. Even if their income is generally lower than that 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 profession. Bankeo matches you free of charge with the ideal expert among more than 1,500 partner firms.
Find my accountantThe first step for most health professionals is incorporation into a corporation. A specialized accountant will help you with:
One of the most important choices for an incorporated professional is to determine the optimal distribution between salary and dividends. This choice has a direct impact on:
A specialized accountant makes tax projections each year to adjust this distribution according to your personal needs, your age and your plans (real estate purchase, retirement, children in school).
Accounting for a professional health practice involves:
Health care professionals generally do not have defined benefit pension plans. The SPA then becomes an essential retirement vehicle. Unlike the RRSP, which must be converted to a RRIF at age 71 (with mandatory withdrawals), the SPA does not require any mandatory conversion or withdrawal. A CPA specializing in taxation plans your phased withdrawal to minimize your overall tax burden in retirement.
The rates depend on the complexity of your practice, the number of structures (SPA, management company) and the services requested. Here is a list of 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 (T1 + T2 + 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 + Lawyer) | 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 if accounting fees seem high, an accountant specializing in health generally generates tax savings of $20,000 to $50,000 per year thanks to the optimization of your structure. The return on investment is almost immediate. To compare accounting rates in Quebec, see our complete guide.
A specialized accountant makes sure that you claim all allowable deductions. Here are the main categories:
Professional orders impose mandatory continuing education hours. These expenses are fully deductible:
Not all CPAs are created equal when it comes to accounting for health professionals. Here are the essential criteria to make the right choice :
Prepare for that first appointment with our guide to preparing for your meeting with an accountant.
Looking for a healthcare accountant on your own can take weeks and doesn't guarantee you'll find the right match. Bankeo simplifies this process:
Whether you are a general practitioner in Montreal, a dentist in Quebec City or a pharmacist owner in the region, Bankeo covers all of Quebec.
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Healthcare professionals often make the same mistakes when it comes to accounting and taxation:
The Ordre des CPA du Québec recommends reviewing your tax planning every year, especially if your income has changed by more than 10% or if your family situation has changed. For a self-employed health worker considering incorporation, the ideal time is often the start of a new fiscal year.
Most professionals governed by an order can incorporate, including doctors, dentists, pharmacists, optometrists, chiropractors and psychologists. Each order has its own rules governing the practice of the company. Check with your professional order for the specific conditions that apply to your practice.
Initial incorporation costs between $3,000 and $8,000 (accounting fees + legal fees), depending on whether you opt for a SPC alone or a SPC with a management company. These costs generally pay for themselves in the first year thanks to tax savings.
Incorporation generally becomes advantageous when you can save $25,000 or more per year on a regular basis. For medical specialists earning $300,000 or more, the advantage is almost systematic.
The SPA (joint stock company) is the structure that carries out your professional activity and receives your fees. The management company (holdco) is a second company that holds the shares of the SPA and serves to protect accumulated investments, facilitate intergenerational transfer and access certain tax exemptions.
If the doctor is only salaried, his accounting needs are simpler. However, the majority of physicians in Quebec have a mixed remuneration (RAMQ + acts in private clinics), which justifies a specialized accountant.
Frequently forgotten deductions include continuing education and convention fees (including travel), interest on loans for the purchase of shares in a clinic, home office expenses (if applicable), and replacement staff recruitment fees.
No, the pharmacist owner has retail management needs (inventory, margins, large staff) in addition to professional accounting. Its bookkeeping is usually more complex due to the high volume of daily transactions.
Yes, you can change accountants at any time. Ideally, you should do this after you file your annual returns to avoid transition complications. Your new accountant will request the records from the old firm.
Absolutely. Bankeo matches healthcare professionals with specialized accountants free of charge from its network of more than 1,500 partner firms in Quebec. You choose the number of accountants you want to meet.
The most widely used software is QuickBooks and Sage for general accounting, combined with practice management software (EMR) for billing. Your specialist accountant can recommend the optimal combination for your practice. Check out our guide to accounting software in Quebec for a complete comparison.
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