Switching accountants vs staying: when a clinic should move
TL;DR: Most owners who want to fire their accountant do not have a bad accountant. They have the wrong kind of help for the size they have grown into, which is a different problem with a different fix. Below: how to tell those two apart, what a switch actually costs in your time rather than in fees, when in the year to move, and what to ask a replacement before you sign.
Option A
Stay and fix the relationship
Keep your current accountant and change what you ask of them. Cheapest option by a distance, and the right one more often than most owners expect. Works when the work is accurate but narrow.
Option B
Switch
Move to a new firm. Costs you real time, not just fees, and the cost lands mostly on you rather than on them. Worth it when the problem is accuracy, responsiveness, or a ceiling the current firm cannot clear.
| Category | Stay and fix the relationship | Switch |
|---|---|---|
| The problem it actually solves | A scope problem. Your books are right, but nobody is telling you what they mean, and nobody has ever mentioned your margin by location or by provider. | An accuracy or trust problem. Numbers arrive late, arrive wrong, or change after you ask about them. No amount of rescoping fixes that. |
| The misdiagnosis to rule out first | Most owners who want to switch have outgrown a bookkeeper rather than hired a bad one. A bookkeeper records what happened. That is the job, done correctly, and no amount of pressure turns it into forward-looking analysis. | If you switch to another firm doing the same scope of work, you will have paid the switching cost and bought the same ceiling. Same job, new logo. |
| What it costs you | One difficult conversation and a written scope. If it works, you are done for the price of an afternoon. | Your time, mostly. Expect to re-explain your chart of accounts, your payer mix, and every non-obvious entry your last firm never documented. Budget for a period where the new firm is slower than the old one, because they are learning what your predecessor already knew. |
| Timing within the year | Any time. Rescoping does not touch your filing calendar. | Cleanest immediately after a year-end close, when the prior year is finished and signed off and the new firm starts from a closed set of books. Mid-year is workable but leaves a seam in the record that somebody has to own at year-end. The worst time is inside filing season, when both firms are at capacity and neither will give you attention. |
| What actually transfers | Nothing moves, which is the point. | Less than owners expect. Your accounting file and bank feeds move. Prior-year workpapers, the reasoning behind entries, and any institutional memory about why something is booked the way it is generally do not, unless you ask for them explicitly and in writing before you give notice. |
| Risk if you get it wrong | You spend another year without the information you needed, and find out at the point where the decision was already made. | A gap in continuity at year-end, and a filing calendar nobody owns during the handover. Both are avoidable, and both are common precisely because they are avoidable and therefore nobody plans for them. |
Diagnose the problem before you change the supplier
Ask one question before anything else: in the last twelve months, has your accountant been wrong, or have they been narrow? If the numbers were accurate and on time but nobody ever told you which location was carrying the others, that is not a firm to fire. That is a scope you never bought, and you can often buy it from the firm you already have, or alongside them. If the numbers themselves were late, wrong, or unexplainable, no rescope will fix that and the switching cost is worth paying. Watch for a third trap: switching for a scope problem, buying the same scope from a new firm, and concluding eighteen months later that accountants are all the same.
Frequently Asked Questions
How do I hire a fractional CFO?+
Start by writing down the three decisions you are trying to make in the next year, because that is what determines whether you need a CFO at all rather than better reporting. Then ask any candidate to walk you through a client's monthly package, with the numbers redacted. You are looking for whether it drives a decision or just reports history. Ask who does the work, since some firms sell a senior name and staff the engagement with someone else. Ask what happens in month one, and be suspicious of an answer that does not start with cleaning something up, because it always does. Finally, agree what you get monthly and in writing before you sign, since scope drift is the most common reason these engagements disappoint.
When in the year should I switch accountants?+
Immediately after year-end close is cleanest: the prior year is finished and signed off, and the new firm starts from a closed set of books rather than reconstructing a partial year. Mid-year is workable, but somebody has to own the seam at year-end, and you should decide who before you move rather than after. Avoid moving inside filing season entirely. Both firms are at capacity, the outgoing one has no incentive to help, and you will get the worst version of both.
What should I ask my current accountant before deciding?+
Ask them what your margin was by location, or by provider, last quarter. It is a fair question and the answer tells you almost everything. If they can answer it, you have a capable firm and a scope problem you can fix in a conversation. If the answer is that the data does not support it, ask what it would take to get there and what it would cost. A good firm will tell you plainly, and sometimes the answer is that you need a different kind of help alongside them, which is a legitimate thing for them to say.
Will I lose anything by switching mid-year?+
Continuity, mostly, and it is recoverable if you plan for it. Before you give notice, ask in writing for prior-year workpapers, the depreciation schedule, any adjusting entries with their reasoning, and access to filings already submitted. Your accounting file and bank feeds transfer without much friction. What does not transfer is why things are booked the way they are, and that knowledge is worth more than the file itself when someone new has to close your year.
Is it cheaper to stay?+
In the first year, almost always, because the real cost of switching is your own time rather than the fee difference. Over three years the calculation usually reverses if the reason you wanted to move was real. The question is not which is cheaper this year. It is whether the information you are missing is changing decisions you are already making.
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Founder of Sorso and a CFA charterholder. Before Sorso, Stan spent 19 years in corporate finance at institutions including UniCredit and Société Générale — managing a $450M loan portfolio and making senior partner at a major mezzanine lender by 29 — then built a fractional CFO firm exclusively for outpatient healthcare clinics.