Accountant for doctors and medical practices.
A specialist accountant for doctors, not a generalist who sees one physician's return a year. We handle tax planning, bookkeeping and corporate accounting for medical practices the way they actually run, from family physicians in Whitby, Oshawa and Ajax to hospital-based specialists and locums across the GTA, all from a chartered professional accountant (CPA, CA) with 20+ years working with medical clients.
Medical accounting has its own playbook.
Most general accountants treat a medical practice like any other small business. It isn't. OHIP billings flow differently from regular receivables. Locum income arrives as a mix of T4, T4A and corp-to-corp, often in the same month. Your clinical equipment depreciates across several different CCA classes. And your Medicine Professional Corporation runs on share-ownership rules the College sets, while the small business deduction interacts with passive investment income in ways that catch incorporated doctors off guard.
So yes, a doctor genuinely needs a specialized accountant for doctors, not a generalist learning on your file. We've handled tax planning, bookkeeping and corporate accounting for physicians, surgeons and other medical professionals across Durham Region and the GTA for over 20 years. We know the tax laws that apply to a medical practice, the patterns are familiar, the planning windows are clear, and the tax planning wins are real. Less guesswork for you, fewer surprises at year-end.
Medical accounting services, the full picture.
One firm for tax, bookkeeping, payroll and advisory services. One point of contact, one consistent set of advice we personalize to how your medical practice runs, and nothing falls between your accountant and your bookkeeper because they are the same team, so you can focus on patient care.
Personal and corporate tax
Your personal T1 and your Medicine Professional Corporation T2 tax return filed together, planned together, and on time every year, with the salary and dividend mix set for tax efficiency.
OHIP and billing reconciliation
Monthly reconciliation of your OHIP remittance reports against your books, so revenue is right at year-end and the financial reports show the real cash flow of the practice.
Locum income tracking
Income from multiple sites and arrangements reconciled cleanly, with the right tax treatment applied to each, so the T1 doesn't surprise anyone in April.
Incorporation and tax planning
Whether to incorporate a Medicine Professional Corporation, when, and how to pay yourself once you do. Salary, dividends or both, modelled as part of your wider tax planning to lower your overall tax liabilities and optimize how you draw income.
Payroll and contractor pay
Payroll for nurses, office and admin staff run cleanly, with the right T4s and T4As for contracted services at year-end and source deductions remitted on time.
Group practice accounting
Profit splits, inter-corporate dividends and shareholder agreements coordinated with your lawyer, with the medical accounting kept consistent across the group.
Four things most accountants miss.
These are the questions that come up almost every time a medical practice changes accountants. Worth knowing whether or not we end up working together.
Most physician billings are HST-exempt, but not all of them
OHIP-insured services and most clinical care are exempt from HST, which is why you do not charge it, and why you generally cannot claim input tax credits on the expenses behind that work. But cosmetic procedures that are not for medical or reconstructive purposes, and third-party services such as medico-legal reports and independent medical examinations, are taxable. Since the 2013 rules, the deciding factor is the purpose of the service, not who pays for it: if the work is not a qualifying health care supply for the patient, it is taxable. A doctor doing any taxable work has to register and remit HST on that portion. Most practices either skip the registration when they need one or charge HST on services that should have been exempt.
Locum income complicates the structure
Locum work can be paid through your Medicine Professional Corporation, taken personally as self-employed business income, or paid as employment income on a T4, depending on the host arrangement. Each path has a different tax outcome and different source-deduction treatment. Picking the wrong one costs thousands and can trip the passive-income limits inside your corporation. We look at the actual arrangement and set it up so the characterization holds up.
Who can own shares of your professional corporation
Ontario physicians can incorporate a Medicine Professional Corporation, but the College of Physicians and Surgeons of Ontario sets who can hold the shares: all voting shares stay with physicians, and non-voting shares are limited to a spouse, child or parent, or a trust for minor children. Those share rules, not a special medical version of the CRA's TOSI rules, are what really narrow income-splitting for a medical practice. TOSI applies to a professional corporation the same way it applies to any private company. It is worth a real conversation before you set up the structure.
Passive investment income shrinks your small business deduction
Once your corporation and its associated companies earn more than $50,000 of adjusted aggregate investment income in a year, access to the small business deduction starts grinding down, $5 of business limit for every $1 of investment income over the line, and it is gone entirely at $150,000. Long-term investing inside the corporation without a plan is one of the most common avoidable tax leaks for established doctors. We model the drawdown and the investment mix so the deduction stays intact.
Three kinds of medical clients.
Family physicians
Solo practitioners and small group clinics. We handle the personal tax return, the Medicine Professional Corporation return, payroll for office staff, and quarterly check-ins on cash flow.
Specialists
Hospital-based or clinic-based specialists with mixed billing structures. We coordinate the hospital payroll, locum work and any private-pay or taxable revenue, and keep the corporate tax planning consistent across all of it.
Locums and early-career physicians
Newer doctors earning across multiple sites. We sort out the tax structure, advise on incorporation timing, and keep instalments accurate so the first big tax year doesn't catch you out.
You'll work directly with Elena.
EK CPA Pro is owner-operated. When you call, you're talking to the CPA, CA who's actually doing the work, not a junior who hands the file off at year-end. Elena has been working with owner-operated businesses across Durham Region since 2009, and is a graduate of CPA Canada's In-Depth Tax Program.
Questions doctors ask first.
Do medical practices really need a specialized accountant?
Most do. A medical practice has HST-exempt billing with taxable exceptions, equipment spread across several CCA classes, locum income that can be taxed three different ways, and a Medicine Professional Corporation the College regulates. A general accountant can miss all of it. A specialized accountant for doctors has seen the patterns before, which usually means cleaner books, lower tax and fewer surprises. That is the whole reason medical accounting exists as its own thing.
Should I incorporate my medical practice?
Usually yes once your billings comfortably exceed what you spend personally, because the small business deduction gives you a much lower tax rate on the earnings you leave in the corporation. There is no fixed income threshold set in law. It depends on your debt, your spouse's income, what you are saving for and your retirement plans. We model both options with your real numbers in the first meeting so the incorporation decision is based on facts, not a rule of thumb.
How does HST work for an Ontario doctor?
OHIP-insured services and clinical care provided for a patient's health are exempt, so you do not charge HST, and you generally cannot claim input tax credits on the related expenses. Work that is taxable, such as cosmetic procedures that are not for medical reasons, medico-legal reports and independent medical examinations, is the exception. Only that taxable revenue counts toward the $30,000 small-supplier threshold over four rolling quarters. If you cross it, you register and charge HST on the taxable portion only. We review your billings and tell you exactly where you stand.
Can I pay my spouse a dividend through my Medicine Professional Corporation?
It is limited. The College restricts who can own shares of a Medicine Professional Corporation, so the structures that work for non-professional businesses are narrower for physicians. The CRA's TOSI rules then apply to dividends paid to family members the same way they apply to any private company, usually taxing them at the top rate unless an exclusion applies. There are still planning opportunities. We walk through what is actually available in your situation.
What can I deduct as a physician?
Most operating costs of running the practice: clinic rent, staff wages, medical supplies, malpractice insurance, association dues, continuing education and equipment depreciation. Clinical equipment usually falls in CCA Class 8, with computers and imaging hardware in faster classes, so the deduction is taken at the right rate. The grey areas are usually vehicle, home office, and conferences with travel and meals. We go through the list in the first meeting and tell you what holds up with the CRA.
How do you bill?
Fixed-fee, quoted up front. You will know the cost of your year-end, your tax return and your monthly bookkeeping before we start. No surprise invoices, no hourly billing.