A cardiologist wouldn’t refer a complex arrhythmia case to a GP simply because both are doctors. Yet many medical professionals do the financial equivalent every year – they hand a genuinely complex financial life to a general practice accountant who also does tax returns for cafés, tradies, and retail shops.
It’s not that generalist accountants are bad at their jobs. It’s that a doctor’s financial situation is a specialised field in its own right, with its own rules, traps, and opportunities that most generalist practices simply don’t see often enough to master.
This article looks at what actually makes medical finances different, where generalist advice tends to fall short, and what a specialist medical accountant in Australia should be doing for you that a standard tax agent usually isn’t.
Why a Doctor's Financial Situation Isn't "Just Another Client"
On paper, a doctor’s tax return might not look unusual – salary and wages, maybe some investment income, standard deductions. But underneath that, several things are happening at once that rarely occur together in other professions:
- Career-stage complexity. A doctor’s financial position can change dramatically every few years — from PGY resident, to registrar, to specialist, to practice owner or partner. Each stage has different income structures, entitlements, and tax exposure.
- Personal Services Income (PSI) rules. Many specialists and locums earn income that is largely a result of their personal effort and expertise. The ATO’s PSI rules significantly limit which structures and deductions are available, and getting this wrong can trigger reassessments years later.
- High marginal tax rates from early in a career. Registrars and specialists often move into the top tax brackets well before they’ve built any real asset base, which makes structuring and timing decisions far more valuable than for the average taxpayer.
- Division 293 tax. Higher-income doctors are frequently caught by Division 293, an additional 15% tax on concessional super contributions once combined income crosses the $250,000 threshold. A generalist accountant who rarely deals with this bracket can easily miss the planning opportunities around it.
- Practice ownership and multiple income streams. Many doctors earn from a mix of hospital employment, private billings, locum work, and practice ownership — each taxed and structured differently.
- Profession-specific deductions. CPD, college fees, indemnity insurance, registration costs, and equipment don’t always get claimed correctly by accountants unfamiliar with medical work patterns.
None of this is exotic. It’s simply specific — and specificity is exactly what gets lost when an accountant is spread across every industry rather than focused on one.
Where Generalist Advice Usually Falls Short
The mistakes we see most often aren’t dramatic. They’re quiet, compounding, and usually only become obvious years later when a structure review or an ATO letter forces the issue.
- The wrong entity structure from day one. A sole trader structure that made sense as a registrar can become expensive and inflexible once a specialist starts private billing. Company and trust structures each carry different tax, asset-protection, and succession implications — and PSI rules restrict which structures are even valid for personal-effort income.
- Missed or misapplied deductions. Generalist accountants sometimes under-claim legitimate profession-specific expenses out of caution, or over-claim in ways that don’t hold up to ATO scrutiny — both are costly in different ways.
- No forward planning around Division 293 or contribution caps. For 2026–27, the concessional (before-tax) super contributions cap is $32,500, and the non-concessional cap is $130,000. Doctors who don’t plan contributions against these caps — and against the Division 293 threshold — can end up paying more tax than necessary, or breaching caps unintentionally.
- Reactive rather than proactive advice. Many practices only hear from their accountant once a year, at tax time. By then, most of the opportunities to actually change the outcome have already passed.
What a Specialist Medical Accountant Does Differently
At MediSuccess, medical professionals are the entire focus of the practice — not one segment among many. Founded in 2011 by Hitesh Mohanlal, Australian qualified Chartered Accountant, the firm works exclusively with doctors, specialists, GPs, dentists, and allied health professionals across Australia.
That focus changes the nature of the advice in a few concrete ways:
- Structuring is reviewed against your career stage, not just this year’s return. The right structure for a hospital-employed registrar is rarely the right structure for a specialist five years into private practice.
- Tax planning happens throughout the year, not just at lodgement. This includes reviewing contributions against caps, timing income and deductions, and flagging Division 293 exposure before it becomes a surprise bill.
- Deductions are claimed with confidence, not guesswork, because the firm sees the same categories of expense — CPD, indemnity insurance, equipment, locum travel — across hundreds of medical clients rather than a handful.
- Structure reviews catch expensive errors early. In one case shared by a client, a structure and prior-return review uncovered years of incorrect advice from a previous accountant, leading to a negotiated outcome with the ATO that reduced penalties and interest by close to $100,000. In another, a full review of a client’s financial arrangements identified savings of over $1.7 million across a 24-year horizon. These aren’t typical outcomes for every client, but they illustrate what’s possible when someone who understands medical practice economics actually looks closely.
How to Choose the Right Medical Accountant
If you’re assessing whether your current accountant is the right fit, a few questions are worth asking honestly:
- Do they work with other medical professionals, or are you one of a handful of exceptions in their client list?
- Do they proactively raise structuring and super contribution planning, or only respond when you ask?
- Can they explain PSI rules and Division 293 in plain terms, specific to your situation?
- Do they review your structure periodically as your career and income change, rather than setting it once and leaving it?
- Is their advice integrated — connecting tax, bookkeeping, super, and business planning — or handled in silos?
If the answer to most of these is no, it’s worth getting a second opinion, particularly at career inflection points such as moving from employed specialist to practice owner, or when income first pushes into the top tax bracket.
Getting Started
Medical finances aren’t more complicated because doctors are bad with money — they’re complicated because the rules genuinely are different for this profession. A medical accountant who works exclusively with healthcare professionals is better placed to catch the details that a generalist, however competent, simply won’t see often enough to specialise in.
If you’d like a second opinion on your current structure or tax position, MediSuccess offers a free consultation to review where things stand and where there may be room to improve them.
Frequently Asked Questions
A medical accountant works specifically with doctors, specialists, dentists, and other healthcare professionals, so they deal daily with issues like Personal Services Income rules, Division 293 tax, medical practice structuring, and profession-specific deductions. A generalist accountant may handle these correctly, but sees them far less often.
It’s not essential in the earliest years when income and structures are simple, but it becomes increasingly valuable as income rises and career decisions — such as moving into private billing or practice ownership — start to have real tax and structuring consequences.
There isn’t a single “best” structure — it depends on your income sources, whether PSI rules apply, your asset-protection needs, and your long-term goals. A structure that suits a solo specialist may not suit a group practice or a practice owner with staff.
For the 2026–27 financial year, the concessional (before-tax) contributions cap is $32,500 and the non-concessional cap is $130,000. Higher-income doctors should also be aware of Division 293 tax, an additional 15% on concessional contributions once combined income exceeds $250,000.
At minimum annually, but ideally whenever there’s a material change — a new position, a move into private practice, taking on a practice, or a significant change in income.
MediSuccess is based in Brisbane but works with medical professionals, practices, and specialists across Australia.
