Beyond the Drill: How Tax Evasion Erodes Healthcare's Foundation

MONTRÉAL, QC – December 12, 2025 – For decades, patients knew Dr. Hanna Elian as a general dentist in his Mont-Royal clinic, a professional entrusted with their health. But behind the clinical facade, a separate set of books was being kept. This fall, that hidden ledger came to light when Dr. Elian pleaded guilty to tax evasion, a crime that has now cost him a fine of $313,262.

The case, which concluded at the Montréal Courthouse on September 2, 2025, serves as a stark reminder that the impact of professional misconduct often extends far beyond the walls of a clinic or office. It strikes at the very foundation of public trust and the financial viability of the community services we all depend on, including the healthcare system itself.

The Anatomy of Deception

According to court records released by the Canada Revenue Agency (CRA), the scheme was straightforward in its design but significant in its scale. Over a period of three years—from 2015 to 2017—Dr. Elian failed to report a staggering $1,188,870 in professional income.

The untaxed revenue stemmed from arrangements with independent dentists who worked out of his clinic, Clinique Dentaire Hanna Elian at the Centre Rockland. These associates paid Dr. Elian a portion of their fees for the use of his clinic's space, equipment, and staff. While payments from some dentists were properly deposited into the clinic's business account and reported, a critical portion was not. Cheques from two specific dentists were systematically diverted into Dr. Elian's personal bank account, effectively making the income invisible to the tax system.

By intentionally omitting this income from his tax returns, Dr. Elian evaded $313,262 in federal income tax. The court-imposed fine, representing 100% of the taxes he sought to avoid, sends a clear message of accountability. However, the case also raises deeper questions about the intersection of professional ethics and financial integrity.

A Crack in Professional Trust

For any healthcare provider, trust is the most valuable currency. Yet, financial misconduct, even when seemingly separate from clinical practice, can irrevocably tarnish a professional's reputation. Online reviews for Dr. Elian’s practice paint a complicated picture. While many long-time patients celebrate his gentle approach and clinical skill, a growing number of recent comments raise alarms about financial practices, with some alleging a focus that is "all about the money" and pressure to accept expensive procedures with requests for cash payments.

This sentiment reflects a broader societal concern. According to a November 2024 Angus Reid Institute poll, an overwhelming 91% of Canadians believe tax evasion is "prolific" and happens frequently. This widespread perception that many are not paying their fair share, particularly among high-income earners, breeds cynicism and undermines the principle of a fair tax system. When a trusted professional like a dentist is convicted of such a crime, it reinforces this public skepticism and damages the credibility of the profession as a whole.

Every dollar of evaded tax is a dollar removed from public coffers—funds designated for roads, schools, and, critically, healthcare. The $313,262 Dr. Elian failed to pay is not an abstract number; it represents tangible resources that could have funded nursing positions, purchased medical equipment, or supported community mental health initiatives.

The CRA's Widening Net

Dr. Elian’s case is not an isolated incident but rather a high-profile example of the CRA's increasingly aggressive stance against tax evasion. The agency has made it clear that professionals and small business owners are under heightened scrutiny. Between April 2020 and March 2025, the CRA’s enforcement actions led to the conviction of 106 taxpayers for evading over $39 million in taxes, resulting in $24.5 million in fines and a combined 98 years of jail time.

Sources familiar with CRA audit practices note that medical and dental corporations are often subject to "particularly thorough" examinations. Auditors meticulously review billing systems, supply costs, and staff classifications to uncover discrepancies. With enhanced data analytics and a growing number of auditors, the agency's ability to detect hidden income and complex evasion schemes is stronger than ever.

In its announcement, the CRA stated it is "dedicated to maintaining the integrity of Canada's tax system, thereby contributing to the social and economic well-being of Canadians." This public-facing enforcement serves a dual purpose: to punish non-compliance and to deter others who might be tempted to hide income. For every professional like Dr. Elian who is caught, the CRA hopes countless others are reminded of the serious consequences, which can include a criminal record, jail time, and professional ruin.

A Profession Under Pressure

While tax evasion is a criminal act without excuse, Dr. Elian's case unfolds against a backdrop of increasing financial complexity and pressure within the dental profession. Like many small businesses, dental practices navigate significant overhead costs and complex regulatory environments. This landscape is about to become even more challenging.

Effective January 1, 2025, the CRA is revoking a long-standing administrative policy related to Goods and Services Tax/Harmonized Sales Tax (GST/HST) for dentists. Previously, dentists could use a simplified method to claim input tax credits (ITCs). The new rules will require meticulous record-keeping to justify every claim, a change that will significantly increase the administrative burden on small and medium-sized practices.

This regulatory shift, combined with ongoing disputes in provinces like Quebec over public reimbursement rates, highlights the financial pressures many practitioners face. It does not justify illegal activity, but it does underscore the need for robust financial literacy and ethical guidance from professional associations. The Canadian Dental Association and its provincial counterparts provide tax resources, but cases like this one demonstrate the need for a continued emphasis on the profound ethical link between paying taxes and upholding the social contract.

Ultimately, the integrity of our healthcare system relies not only on clinical excellence but also on the ethical conduct of its professionals in all aspects of their lives. When that trust is broken, the cost is measured not just in fines paid, but in the erosion of public confidence and the weakening of the very community services that professionals are sworn to support.