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Looking for a CPA for physicians?

Year round tax planning and preparation from a physician founded firm. Our Tax Attorneys, CPAs, or Enrolled Agents work only with physicians, serving thousands in all 50 states.

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The Overview

You Are Not the Tax Client a Generalist CPA Was Trained For

Your tax picture is not the standard return tax software was built for. It is W-2 wages, 1099 contracts, K-1 distributions, multi-state licensing, the retirement plan stacking only physicians can access, and a series of elections that have to be made on time and in the right order. A generalist CPA was not trained for any of it.

 

Doc Wealth is a tax planning and preparation firm built for physicians only: the accountant for physicians and other medical professionals who need more than a return filed once a year. Our Tax Attorneys, CPAs, or Enrolled Agents handle your planning and your filing as one coordinated team, all year, in every state where you practice.

In This Guide

01

Why a Generalist CPA Does Not Work for a Physician

02

What to Look For in a Physician CPA

03

The Doc Wealth Tax Team

04

How Doc Wealth Compares

05

The Doc Wealth Process

06

What Engagements Actually Look Like

07

Who We Serve

08

Frequently Asked Questions

The Stakes

Why physicians need an accountant who only works with physicians

Your tax picture is more complicated than almost any other high earning professional's. You may have W-2 wages from a hospital, 1099 income from telehealth or moonlighting, and K-1 distributions from a practice ownership stake, sometimes across two or three states. Add your student loan repayment strategy, your backdoor Roth contributions, an HSA, real estate K-1s, and the question of whether to elect S-Corp status on the 1099 side, and the result is a return that a generalist CPA was never trained to optimize.

​

A typical generalist engagement is reactive. Forms in, return out. There is no June phone call to suggest electing S-Corp status before the deadline closes. There is no review of whether your state offers a Pass Through Entity Tax election worth a meaningful chunk of your liability. There is no analysis of how your Solo 401(k) and a cash balance plan could stack to shelter more pretax income if structured correctly.

​

A generalist CPA does generalist CPA work competently: they file what comes in. The problem is not the work. The problem is that filing is roughly half of physician tax work, and the proactive half is where the value lives.

​

When we reviewed 500 physician tax returns prepared elsewhere, the gaps we saw most often were a Solo 401(k) that was missing or not fully funded, no S-Corp election on 1099 income, locum physicians with states missing from their filings, and no Pass Through Entity Tax election in states that offer one.

The gap between filing and proactive physician tax planning at physician income levels is substantial, and it compounds. Three years of overpayment is a paid off student loan. Five years is a real estate down payment. Ten years is a paid off mortgage.

The Checklist

What to Look For in a Physician CPA

Whether you search for a physician CPA, a CPA for medical professionals, or just an accountant who returns calls, these are the five things that separate a tax team built for physicians from a generalist.

1

Physician only client base

A firm that serves physicians as one of many client verticals will not have the depth on physician specific issues: entity structures for medical practices, multi-state licensing implications, PSLF and student loan tax interactions, the retirement plan stacking that exists nowhere else. Ask any prospective firm what percentage of their clients are physicians. If the answer is anything other than "all of them," you are talking to a generalist.

2

Year round engagement, not seasonal filing

Your tax outcome for a given year is largely set by November. Decisions made in December (entity elections, retirement contributions, charitable giving, equipment purchases) drive the result. A CPA who only meets with you in March is performing an autopsy. You need preventive medicine.

3

A coordinated team, not a single point of contact

Different parts of your tax life require different specialties. Entity structuring, Pass Through Entity Tax elections, and trust planning are tax attorney work. Compliance and filing are CPA work. IRS representation authority is Enrolled Agent work. Most firms staff one of these three.

 

The strongest firms integrate all three.

 

When your plan calls for entity formation, we bring those specialties together with our partners and walk you through the setup, keeping the legal and tax considerations connected.

4

Prompt, dependable communication, with named team members you can reach directly

Tax questions arise throughout the year, not just during filing season. Look for year round communication with your CPA, Enrolled Agent, or Accountant, so you can discuss questions and changes as you plan ahead.

5

Multi-state capability

A physician CPA who works in one state and refuses to handle multi-state filings is a deal breaker if you take locum work, see telemedicine patients across state lines, or hold real estate outside your home state.

Why Doc Wealth

Founded by a physician, run by a credentialed tax team

A physician accountant is only useful if the whole team behind them is built the same way. Here is who works on your file.

 

Doc Wealth was co-founded by Dr. Mark Applegate, a board certified emergency medicine physician who could not find a tax team that worked the way physicians actually need one to work. The team is structured to mirror the three legal credentials that matter for physician tax work.

1

Tax Attorneys

Tax Attorneys lead complex structuring decisions: entity elections, Pass Through Entity Tax planning, trust formation, and audit defense strategy. They hold a J.D. and are admitted to the bar. Tax law training is graduate-level work, not a CPA continuing education topic.

2

CPAs

CPAs drive the compliance and filing engine: preparing returns, running quarterly projections, managing payroll for S-Corp clients, and coordinating bookkeeping. They hold an active CPA license and meet annual continuing education requirements.

3

Enrolled Agents

Enrolled Agents carry the IRS representation authority. EA status is the highest credential the IRS itself issues, and it allows the holder to represent you directly before the IRS in any matter, in any state. If you are ever audited, you want an EA on your side.

When you engage Doc Wealth, you are assigned a dedicated tax team, not a single advisor and not a rotating cast. The same Tax Attorney, CPA, and Enrolled Agent work on your account month after month. They know your income structure, your entity, your state mix, and your goals. You receive year round communication with your CPA, Enrolled Agent, or Accountant.

Last updated September 2026

Meet our physician tax team

Side by Side

Doc Wealth vs. a local CPA vs. a national tax chain

Most physician readers have worked with at least one generalist CPA. Here is how the typical generalist engagement compares to the Doc Wealth model.

For Comparison

The typical generalist CPA engagement

One meeting per year, usually in February or March

Forms in, return out

No proactive entity structuring, no Pass Through Entity Tax review, no retirement plan stacking analysis

Limited or no responsiveness between filing seasons

A single point of contact, often a generalist CPA serving dozens of unrelated business types

Filing only. Planning is not part of the engagement

The Standard

The Doc Wealth Model

Year round engagement with quarterly projections and mid-year course corrections

A dedicated team of Tax Attorneys, CPAs, and Enrolled Agents working on your account together

Year round communication with your CPA, Enrolled Agent, or Accountant

Multi-state filing capability, which matters for locum, telemedicine, and real estate

Proactive review of every available physician strategy: S-Corp election, retirement plan stacking, Pass Through Entity Tax, Augusta Rule, hiring children, real estate cost segregation, and charitable giving

An education platform to help you understand the tax work being done on your behalf

For a deeper side by side comparison of what a generalist misses at physician income levels, see why physicians need a specialized CPA.

That is the model on paper. Here is how it actually starts.

tech

The Plan

Tax preparation for physicians, and the planning that comes before it

Physician tax preparation is the last step of the year, not the first. Here is the order things happen in.

01

Step 1

Book a free discovery call

You tell us about your income structure, your current setup, and your goals. We listen.

02

Step 2

We analyze your complete tax picture

Our team reviews your last two filed returns, your entity structure, your retirement plans, and your state mix to identify the planning moves your situation supports.

03

Step 3

Implementation, Done for You

A Tax Attorney, CPA, and Enrolled Agent work together on your account, not once a year but every month.

In Practice

What Engagements Actually Look Like

These are representative engagements. What applies to you depends on your income, entities and states.

Emergency medicine, 1099

A physician earning $480,000 in independent contractor income switched from a sole proprietorship working with a generalist CPA to an S-Corp working with Doc Wealth. We implemented S-Corp election, a Solo 401(k) plus cash balance plan stack, and a state Pass Through Entity Tax election. The return is now structured around the physician's actual income mix.

Dual W-2 dermatology and primary care couple, California

On a $750,000 household income we completed backdoor Roth contributions, established an HSA, and implemented a charitable bunching strategy through a donor-advised fund. The structure carries forward year after year.

Locum tenens hospitalist, four states

Transitioned to a single LLC with S-Corp election, built a multi-state filing protocol, and set up quarterly projections. The combination eliminated chronic underpayment penalties and added physician specific planning the previous engagement had missed.

For longer walkthroughs of representative engagements, see physician case studies and physician reviews.

Built For You

The Tax Team for W-2 Physicians, 1099 Physicians, Locums and Practice Owners

Doc Wealth works with physicians at every stage and structure:

1099 physicians

The tax team for 1099 physicians: telemedicine contractors, moonlighters, expert witnesses, and anyone with consulting income

W-2 physicians

Hospital employed attendings, academic faculty, and employed group physicians

Practice owners

Solo practitioners and partners in physician owned groups. See how medical practice accounting should run for physician owners.

Locum tenens physicians

Multi-state filings, tax home rules, travel and lodging deductibility

Dual-physician households

Two W-2s, two sets of benefits, often a 1099 in the mix

Our physician tax planning service covers every income type, and physician tax preparation is included with every engagement. Pricing is transparent and structured by complexity.

Answers

Questions physicians ask before hiring a CPA

01

How do I switch tax firms mid-year?

01

How do I switch tax firms mid-year?

02

What states does Doc Wealth serve?

02

What states does Doc Wealth serve?

03

Does Doc Wealth handle both planning and filing?

03

Does Doc Wealth handle both planning and filing?

04

What does onboarding look like?

04

What does onboarding look like?

05

Can Doc Wealth handle my S-Corp election and payroll?

05

Can Doc Wealth handle my S-Corp election and payroll?

06

How is Doc Wealth different from my current tax preparer?

06

How is Doc Wealth different from my current tax preparer?

07

What do most CPAs charge per hour?

07

What do most CPAs charge per hour?

08

What is a medical CPA?

08

What is a medical CPA?

09

What does an accountant for doctors do differently?

09

What does an accountant for doctors do differently?

10

What are the best tax strategies for physicians?

10

What are the best tax strategies for physicians?

11

Do I need a CPA that specializes in doctors?

11

Do I need a CPA that specializes in doctors?

12

What is the difference between tax preparation and tax planning?

12

What is the difference between tax preparation and tax planning?

Resources

Keep Reading

How to Find a Good CPA as a Physician: Tax Planning, Credentials, and Cost

Read more

QuickBooks for a Medical Practice: A Physician Tax Planning Guide to Clean Books

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2026 Solo 401(k) Contribution Limits for Physicians: Tax Planning Math for 1099 and S-Corp Income

Read more

How to Calculate Depreciation on Rental Property for Physicians: A Tax Planning Guide

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Passive Activity Loss Limitations for Physicians: Why Your Rental Losses Get Stuck (and How to Free Them)

Read more

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Disclaimer: This material is intended for educational and informational purposes only and does not constitute tax, legal, accounting, or financial advice. The content is general in nature and may not apply to your specific circumstances. Tax laws and regulations are subject to change and interpretation, and the application of these laws can vary based on individual situations. Before making any decisions, you should consult with a qualified tax advisor or legal counsel.

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