Dentist or surgeon — which would you rather be? – Accounting Today

Did you ever hear the joke that begins: “A dentist, a brain surgeon and a CPA walk into a bar?”

I didn’t either. However, more and more CPAs need to decide if they want to run their practices like dental offices or neurosurgery practices. And there’s nothing funny about that.

You can do well with either approach — as long as you’re deliberate about which path you’re taking. It can’t be a haphazard approach.

Do you want to be a high-volume practice that does lots of repetitive work (like a dentist)? Or do you want to be a low-volume practice that solves complex cases and problems (like a surgeon)?

Two types of CPA firms

If you’re focusing mostly on tax returns, you’re the CPA equivalent of a dentist — serving lots and lots of patients doing routine cleanings and filling cavities. You’re not solving a complex problem (like reconstructions or oral surgery), and you’re getting paid appropriately.

Brain surgery is completely different. There are myriad complex issues, and surgeons are often tasked with preventing a patient from dying on the table. The diagnosis, treatment and follow-up are a lot more in-depth. Therefore, surgeons are highly compensated for their expertise.

Both are strong business models. I know plenty of dentists who make a very good living. They have simply figured out a way to streamline their practices and to get a high volume of patients in and out of their office every day. Their patients keep coming back every six months for routine maintenance. Most will
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