How to Choose a CPA for Doctors in Ontario (2026 Guide)

ByBader A. Chowdry, CPA, CA, LPA

Reviewed by Bader A. Chowdry, CPA, CA, LPA on

How to choose a CPA for doctors Ontario 2026, in one paragraph — MPC share classes, TOSI on family dividends, OHIP reconciliation, and LPA scope.

Quick answer (52 words)

For an Ontario doctor, the right CPA is one who understands Medical Professional Corporation (MPC) share-class rules, TOSI application for family dividends, OHIP reconciliation, and LPA scope for eventual practice sale. Ask any prospective CPA the 12 questions below. Fee should be $8,000–$25,000 annually for a solo incorporated practice.

Last updated: July 30, 2026. Author: Bader A. Chowdry, CPA, CA, LPA — Insight Accounting CPA Professional Corporation, Mississauga ON.

Why doctors need a CPA who specializes — not a generalist?

Most CPAs can file a T2 corporate return. Very few understand how the College of Physicians and Surgeons of Ontario (CPSO) actually regulates Medical Professional Corporations, how OHIP billings should reconcile to your financial statements, or how the Tax on Split Income (TOSI) rules interact with the family-member salaries incorporated doctors used to rely on for tax savings.

The result: incorporated Ontario doctors routinely leave three to seven figures on the table over a career. The three most common mistakes we see when new client doctors switch to Insight from a non-specialized CPA are:

  1. CPSO By-Law 4 non-compliance — share classes drafted incorrectly, dividends paid to non-physician family members without the correct share structure.
  2. TOSI applied loosely — dividends to a stay-at-home spouse continuing to be paid without a documented “excluded business” or “reasonable return” position.
  3. OHIP reconciliation absent — deposits treated as one cash line with no fee-code-level backup for a CRA review.

Any CPA who advertises “we work with doctors” should be able to describe how they handle all three areas. If they cannot — even at a discovery-call level — they are a generalist calling themselves a specialist.

The 12 questions to ask any CPA who says they work with doctors

Use these on 3 firms. Compare answers.

  1. How many incorporated Ontario physician clients do you serve today?
  2. What are the CPSO By-Law 4 share-class requirements for MPCs? (They should answer without notes.)
  3. How do you handle TOSI risk for a spouse who does not work in the practice?
  4. How do you reconcile OHIP remittance deposits to the general ledger — daily, monthly, or annually?
  5. Do you hold a Licensed Public Accountant (LPA) designation? If not, how will you handle a review engagement when I refinance or sell the practice?
  6. What is your annual fee for a solo incorporated family physician with $400K gross billings? What triggers a fee re-quote?
  7. What software do you use for bookkeeping, and can it import my billing-software exports directly?
  8. What is your salary-vs-dividend framework for 2026? Fixed formula or year-by-year modelling?
  9. How do you handle the Personal Services Business (PSB) risk for locums?
  10. How many hours annually do we spend on strategy calls versus compliance?
  11. What is your policy on AI use with client data?
  12. Can you send me your standard engagement letter to review before the second meeting?

Any CPA who cannot answer 10 of the 12 clearly is a generalist. For doctors, that is a fee you cannot afford to pay in downstream tax errors.

LPA scope — why it matters for doctors even if you don’t need audit today

Most solo incorporated Ontario doctors do not need an audit today. Most will need a review engagement (CSRE 2400) at least once — when refinancing the practice’s operating loan, when purchasing a partnership share in a group MPC, or when preparing the practice for sale to another physician or a corporate consolidator.

The problem: if your current CPA does not hold an LPA (Licensed Public Accountant designation per the Public Accounting Act, 2004 Ontario), they cannot sign that review engagement. You will either need to switch CPAs mid-transaction (expensive and stressful) or have the outgoing CPA subcontract the assurance work at a premium.

Insight Accounting CPA holds LPA in-house — Bader signs assurance work directly. Ask any CPA about LPA scope on the first call, even if you do not think you need it today. See CPA Ontario — Public Accounting Licence for the licensing rules.

What does “one worked example” look like for a doctor engagement?

We meet each of these criteria — and we say this as one example, not to imply we are the only firm that does:

Criterion Insight Accounting CPA
Physician clients today 40+ across GTA (family, specialists, locums, dentists)
LPA in-house Yes — Bader signs review engagements
CPSO By-Law 4 workflow Standard onboarding step, documented
OHIP reconciliation Monthly, fee-code-level, matched to bank
TOSI risk review Annual, per client
Fee band 2026 $8,000 (solo) to $25,000 (group/holdco)
Communication cadence Quarterly strategy calls included

If this maps to what you need, book a discovery call. If your specialty is unusual (surgeon with hospital-privilege AFP, dual-practice locum, cross-border U.S./Canadian licence), tell us on the first call — we will confirm fit before quoting.

FAQ — Choosing a CPA for doctors (Ontario 2026)

Q: Does my CPA need to hold an LPA if I’m an Ontario doctor?

A: Not necessarily. LPA (Public Accounting Licence per Public Accounting Act, 2004) is required only for assurance engagements — audits, reviews, and third-party-reliant compilations. Solo incorporated doctors typically do not need one annually. But if you plan to sell the practice, refinance a large operating loan, or join a group MPC, the transaction may trigger a review-engagement requirement. Ask upfront.

Q: How much should a CPA for an Ontario doctor cost in 2026?

A: $8,000–$25,000 annually for a solo incorporated family physician with clean OHIP billings. Specialists, group practices, locum overlays, and U.S. cross-border situations push higher. Cheaper firms exist; most do not run TOSI risk audits or OHIP reconciliations properly and cost more downstream.

Q: How do I know if a CPA understands CPSO By-Law 4?

A: Ask them to describe the share-class requirement (one class of voting share, all owned by physicians authorized by the CPSO) and the Certificate of Authorization renewal process. Ask them to walk you through a corrected share structure for a doctor whose non-physician spouse currently holds voting shares. If they cannot answer without notes, they do not run this workflow regularly.

Q: Can my CPA also do my personal T1?

A: Yes. Most doctor-focused CPA firms package the T1 with the MPC engagement because the salary-vs-dividend decision at the corporate level directly affects the personal return. Verify it is included in your fixed-fee retainer or priced separately in writing.

Q: What if I am a locum doctor — do I need a CPA who understands the PSB risk?

A: Yes, and this is one of the highest-value questions to ask. Personal Services Business (PSB) reclassification denies your MPC the small-business deduction and most expense deductions — making the corp WORSE than a sole proprietorship. A CPA who does not run a PSB risk assessment on locum onboarding is not fit for locum work.

Sources & references

Related Insight Accounting CPA resources

Interviewing CPAs for your medical practice? Put us through the 12 questions above. If we are not the right fit, we will refer you to a firm that is.

Book a 30-min discovery call →

Reviewed by Bader A. Chowdry, CPA, CA, LPA — Insight Accounting CPA Professional Corporation, Mississauga ON. This article is general information, not accounting or tax advice.

Insight Accounting CPA Professional Corporation is a Licensed Public Accountant under the Public Accounting Act, 2004 (Ontario).

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