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Your company as a doctor, dentist or pharmacist: what do you really need to know?

Whether you’re a doctor, dentist or pharmacist, sooner or later you will ask yourself the same question: do I continue working as a sole trader or do I switch to a company structure? The answer depends not only on your income but also on how your practice operates. Think of NIHDI services, nomenclature, on-call duties, aesthetic treatments, investments in equipment or inventory management. It also depends on what you want to build in the long term, both professionally and privately. We’ve outlined the key points below.

Marc Poncelet
•
27 May 2026
Your company as a doctor, dentist or pharmacist: what do you really need to know?

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Why healthcare professionals consider a company structure

The move towards a company structure is almost never an impulsive decision. In practice, healthcare professionals often take this step because:

· colleagues are making the switch

· their income is increasing

· professionals work together within a practice

But the real question is not when others do it, but: what do you wish to achieve with your practice and your income?

The reality is that every healthcare professional’s job has a different dynamic:

· doctors mainly work with NIHDI nomenclature, consultations and on-call duties

· dentists combine nomenclature with aesthetic procedures such as bleaching or aligners

· pharmacists work with margins, reimbursement systems and complex stock

This means that not only your turnover is different but also your cost structure, your risks and your growth opportunities. In other words, there is no standard answer. What works for your colleague is not automatically the right choice for you.

Sole trader vs company: how are they different?

1. General practitioner with stable NIHDI income

Many general practitioners have a relatively predictable practice:

· a steady patient flow

· income from NIHDI services

· additional income from on-call duties

· limited investments

In a sole proprietorship, this means you quickly end up in the highest tax brackets, with a total tax burden that can rise to 45 to 50%.

It’s important to note that in a sole proprietorship, your entire profit is taxed in personal income tax, without any possibility of spreading. A company structure can be beneficial because:

· income can be spread over time

· profits can temporarily remain within the company

· it allows a combination of salary and dividends

Still, there is an important nuance: the advantage is limited if you need most of your income privately. In this type of practice, the difference is often smaller than expected, unless you’re consciously planning for the longer term, for example towards retirement or wealth building.

2. Dentist with a growing practice and investments

Among dentists, we often see a different profile:

· increasing turnover

· a combination of nomenclature and aesthetics

· regular investments in equipment

Think of:

· intraoral scanners

· digital imaging

· CAD/CAM systems

These investments easily amount to anywhere between €80,000 to €150,000. This means you’re not just looking at taxes but also at financing and cash flow. A company structure offers clear advantages here:

· investments can be spread and processed in a tax-efficient way

· peak income can be better absorbed

· cash flow can be managed more effectively

In addition, working with other healthcare professionals also plays a role:

· group practices

· shared costs

· joint investments

Are you in a growth phase or planning significant investments? Then it’s important to properly set up your structure in advance.

3. Pharmacist: cash flow, margin and stock

Pharmacists operate in a different model:

· high turnover

· relatively limited margins

· strong dependence on inventory

Important parameters are:

· stock rotation

· payment terms with wholesalers

· NIHDI reimbursements

As a result, the complexity lies less in taxation and more in the timing of income and expenses. In this case a company structure mainly helps to:

· structure cash flow

· better manage risks

· organise investments

Think for example of absorbing differences between the moment of purchase and reimbursement by the NIHDI.

The focus here is less on ‘saving tax’ and more on financial stability and control. Do you have little manoeuvring room despite a strong turnover? Then the real challenge is often structure instead of taxation.

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The biggest misconception: a company means lower taxes

This is one of the most common mistakes.

Paying out everything as salary

Some healthcare professionals:

· pay out almost their entire profit to themselves

· use the company only as an intermediary

Result:

· high personal income tax

· additional costs for the company

This way you don’t benefit from the lower corporate tax rate, cancelling out the advantage entirely. As a result, there is often no net benefit.

Taking too little salary

The other extreme:

· as little salary as possible

· as much profit as possible retained in the company

Consequences:

· lower social rights

· harder to secure a loan

· limited personal flexibility

In practice, banks still attach great importance to your personal income. This can be particularly significant for young healthcare professionals later on.

The correct approach: balance

The best approach offers a sound balance:

· sufficient salary for your private needs and social protection

· sufficient room within the company for optimisation

This is not a one-off decision but something that must be adjusted annually. This is often where the real difference lies: not in the structure itself but in how it is used.

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VAT: where things often go wrong for (dental) practitioners

1. Aesthetic treatments by doctors

Medical services with a therapeutic purpose are exempt from VAT
However, aesthetic treatments (such as Botox or fillers without medical indication) are generally subject to VAT.

The difficulty lies in the assessment: when is something therapeutic and when not? What we often see:

· no VAT charged

· no separate tracking

· everything booked under a single activity

In the event of an audit:

· VAT is charged retroactively

· often with penalties and interest

Because this often concerns multiple years, amounts can quickly add up.

2. Dentists with mixed services

Dentists combine:

· nomenclature (VAT exempt)

· aesthetic treatments (VAT taxable)

In practice this means:

· correct split per treatment

· proper invoicing

· adapted accounting

One incorrect system leads to structural problems.

3. Pharmacists and VAT

Pharmacists work with:

· multiple VAT rates (6%, 12%, 21%)

· high transaction volumes

Often linked to cash register systems and software so small errors can easily have a major impact.

Unsure whether your VAT was processed correctly? A quick analysis can prevent many issues during an audit.

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Investments: strategic choices with long-term impact

Purchasing a practice premises

Your options:

· private purchase

· through a company

This has an impact on:

· your taxes

· your pension build-up

· taxation upon future sale

What seems fiscally attractive today is not always the case in the long term. This is not a purely tax-driven decision, but a strategic one.

Investments in dentistry

Important questions:

· buy or lease?

· when to invest?

· how to spread the costs?

These choices determine the monthly pressure on your practice. Incorrect decisions often lead to cash flow problems, even with high turnover.

Are you planning an investment? Then it is important to simulate the impact in advance.

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How do you extract money from your company?

Starting healthcare professional

Often:

· focus on saving tax

· low salary

Result:

· limited social protection

· harder to secure a loan

Established healthcare professional

Different questions:

· salary vs dividend

· financing private projects

· wealth accumulation

This evolves with your career and life stage, and is always geared to your situation.

What makes a company interesting?

In practice, we see that a company often becomes interesting when:

· your income is consistently above €90,000 to €100,000

· you’re planning investments

· you’re working in a group practice

· you want to plan for the long term

But more importantly: what do you want to do with your income and your practice?

How we support healthcare professionals

The offices of PIA Group support doctors, dentists and pharmacists with:

· simulations comparing sole proprietorship vs company structure

· guidance when starting up or switching

· VAT analysis for mixed activities

· advice on collaborations and entry into partnerships

· strategy on salary, dividends and investments

We think along with you like an entrepreneur in the healthcare sector. Not only as an accountant, but also as an advisor.

Would you like to know what your best option is?

Every situation is different. That is why we always start by gaining insight into:

· your current structure

· your income and expenses

· your short- and long-term plans

We then translate these insights into a concrete approach. Schedule a no-obligation meeting and discover what makes the difference in your situation.

FAQ: your company as a doctor, dentist or pharmacist

  • When is it interesting for a doctor or dentist to set up a company?

    A company structure is usually interesting when your income is consistently above €90,000 to €100,000 and you don’t need all of your income for private purposes. It can also offer advantages in the case of investments, collaboration in a practice or long-term planning (e.g. pension building). However, it always depends on your personal situation.

  • Do you pay less tax with a company?

    Not automatically. A company can be more tax-efficient, but only if it is used correctly. If you pay out all profit as salary, you will often end up owing the same level of taxes as in a sole proprietorship. The optimisation lies mainly in the combination of salary, retained profit within the company and dividends.

  • What is the difference between a sole proprietorship and a company for healthcare professionals?

    In a sole proprietorship, your entire profit is taxed in personal income tax. In a company, the profit is first taxed under corporate income tax, after which you decide how much to distribute. This offers more flexibility but it also involves more complexity and costs.

  • Do I need to charge VAT on aesthetic treatments as a doctor?

    In many cases, yes. Aesthetic treatments without a therapeutic purpose (such as Botox or fillers) are generally subject to VAT. Medical services with a therapeutic purpose remain exempt. A correct assessment is essential to avoid issues during an audit.

  • What are the VAT rules for dentists offering mixed activities?

    Dentists who perform both nomenclature services (VAT exempt) and aesthetic treatments (VAT taxable) must make a clear distinction. This affects invoicing, accounting and VAT returns. An incorrect system can lead to structural errors.

  • Is a company structure mandatory if I work in a group practice?

    No, it’s not. However, in practice a company is often used to provide a clear structure for the collaboration. Think of agreements on income distribution, costs, investments and liability. Without structure, conflicts arise more easily.

  • Should I buy my practice premises privately or through my company?

    This depends on your long-term plans. Buying privately can be interesting for wealth building, while purchasing through the company may offer advantages in terms of taxation and cash flow. The right choice depends on your situation and future plans.

  • How do I determine my salary in a company structure?

    Your salary should be balanced: high enough to ensure social protection and creditworthiness, but not so high that you lose tax advantages. The optimal combination of salary and other forms of remuneration depends on your specific situation and evolves throughout your career.

  • What are the most common mistakes healthcare professionals make with a company structure?

    Common mistakes include:

    · paying out everything as salary

    · taking too little salary

    · applying VAT incorrectly

    · poorly planning investments

    · starting without a clear strategy

    These mistakes can have a significant financial impact in the long term.

  • How do I know whether a company structure is the right choice for me?

    This is impossible to determine based on general rules. The right approach always starts from your own numbers, your practice and your plans. A sole proprietorship vs company simulation is usually quick to settle the matter and helps avoid wrong decisions.

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