Carlyle Walton started off his career as a health care executive with Metroplex Health System more than 20 years ago.

After he became CFO in 1988, he helped the institution blossom from a 70-bed hospital into a major force in the region. Metroplex now employs more than 1,200 people.

Walton left Metroplex in 1998, but he returned as CEO in 2009. He sat down to talk with the Herald about growth, the future and how he balances the bottom line with a mission to heal.

You did not set out to get into health care. How did that happen?

I began my career in accounting. I was recruited by Ernst and Whinney, at that time one of the big three CPA firms, to their Orlando office. That was connected to Adventist Health System, the company I have worked for now since 1988. I was recruited to Ernst and Whinney in ’85. I was scheduled to stay there for a year and then transfer to the internal audit division. Adventist Health System was an Ernst and Whinney client. During the year I was with Ernst and Whinney, Adventist switched their external auditor. I decided to stay at Ernst and Whinney until 1988, when this opportunity presented itself. But during those years, most of the clients I audited were health care-related clients. So I received a lot of exposure to the many facets of health care. Even though I had other audit clients, I always liked the health care facilities. Even though I was an accountant, I started my career focusing on health care.

What is the difference between being a CEO at a nonprofit and a for-profit institution?

There are valid differences. Why I love what I do is we offer faith-based, nonprofit health care. Now, nonprofit does not mean we do not try to make a bottom line. The only way we can grow is if we have a positive return. But the beauty of that is it all goes back into the community. It all goes back into the employees. It doesn’t go in the pockets of any shareholders or investors. The investors are the community. We are a 501c3 facility. The community owns this hospital. In a for-profit business, the focus is different. The No. 1 responsibility is to create a return for the shareholders.

How do you balance the bottom line with your mission to provide the best possible health care?

It’s one of the biggest challenges. I pray for wisdom every day. You want to be able to provide the highest quality care for your community. And I think part of doing that is recognizing that you can’t be all things to all people. So we have to choose how we deploy the resources that we have. Sure, I’d like to say we do open heart and we do liver transplants and all of those things. But those things require significant resources. So our commitment is to be the best community hospital that we can be, offering primary and secondary care based on the resources that we have.

Are there any new technologies emerging that could change the way Metroplex does business?

Always, always. One of the things we have to always be prudent of is to not get so caught up in the technological rat race that you invest in things when you really can’t optimize their use. But one of the things we’re evaluating is to be able to do robotic surgery here. To get a da Vinci Robot is, give or take, a $2 million investment. And physicians go in and get special training. There are those who think it significantly improves the ability of patients to get back to work and recovery time. As we recruit new physicians, especially surgeons, one of the things they say they really want to do for their patients is robotic surgery. We are in the process of evaluating it. It is used primarily by OBGYNs, general surgeons and urologists. We have an interest in exploring robotic surgery in all three of those specialties. When robotic surgery started, it probably took $10 million to get into the game. Now it is starting to be affordable for community hospitals.

Obamacare is obviously a big issue. How does the uncertainty affect how you do your job?

I start from the premise that I don’t call it Obamacare. In and of itself, that politicizes it. That immediately puts you into this box or that box. I mean, it has a name. It’s the Patient Protection Act. Unfortunately, Obamacare is used as a positive or a negative depending on which side of the aisle you are on. One of the things I enjoy doing is a lecture at the Robbins Institute for Health Policy and Leadership for the incoming MBA class for health care administration. In my most recent lecture, I asked, “How many of you have actually read the Patient Protection Act?” Not a one. Very few people have read the 997 pages of the act, but they take their snippets, whether they listen to FOX or MSNBC, or they listen to their local congressman, and that is what they run with. I think my responsibility as a community leader and a health care executive is to do my homework and not go out there and spout little vignettes or sound bites. So, I’ve taken the time to read the act. I am not going to sit here and tell you I understand everything that it does, but the one thing that everyone agrees on is that the current trajectory of healthcare spending in this nation is unsustainable. The reality is we have to find ways to bend that cost curve. And I see the Patient Protection Act as a very good start. It is far from perfect, at making us have the conversation how we can take care of what is unsustainable. I don’t get caught up in what might happen. I deal with what is on my plate.

Contact Mason Lerner at or (254) 501-7567

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