News & Events

At Caritas helm, a doctor turned dealmaker

De la Torre’s rise fueled by energy, talent, ‘edge’

By Robert Weisman, Liz Kowalczyk, and Casey Ross, Globe Staff  |  March 28, 2010

Wall Street power broker Robert Nardelli remembers being immediately impressed with Dr. Ralph de la Torre last November, when they conversed over drinks and dinner at a California desert resort.

De la Torre, a Boston surgeon running Caritas Christi Health Care, had asked a mutual friend to arrange the meeting with Nardelli, the former Home Depot chief executive who had run Chrysler for a private equity firm.

Making it clear he had closely followed Nardelli’s career, de la Torre asked the older, more experienced businessman for advice on raising cash for his hospital system. Nardelli said he was struck by de la Torre’s boundless energy and ability to jump from engineering to heart surgery to business. “This guy had tremendous edge,’’ he recalled.

Nardelli was sold. Based on that three-hour session at the Marriott Desert Springs Resort & Spa, Nardelli, a top executive at Cerberus Capital Management, paved the way for the New York-based private equity firm to buy Caritas for $830 million. The deal, announced last week, would convert the nonprofit Catholic hospital and physician network into a for-profit company. Crucially, it would leave the 43-year-old de la Torre as chief executive of Caritas, while also putting him in charge of acquiring other hospitals for Cerberus.

The deal, if approved by regulators and the church, would complete de la Torre’s transformation from doctor to dealmaker. Once part of a group of young entrepreneurial heart surgeons, he made more than $1.3 million in 2009 at Caritas and now stands to win a much bigger payout from incentive compensation if he succeeds in building the six-hospital Eastern Massachusetts chain into a national juggernaut.

He has landed here through intellect, moxie, and a relentless work ethic. He works 16-hour days three days a week, and the other two days he goes home to Newton after only 11 hours, so he can tuck in his twin 17-month-old boys.

“I only know how to do things one way — all in,’’ he said in an interview Friday.

Just as important, he has used his formidable skills as a salesman to persuade decision-makers and power brokers to take a chance on him and his bold, risky ideas.

As head of cardiac surgery at Beth Israel Deaconess Medical Center in 2006 and 2007, de la Torre persuaded chief executive Paul Levy and other leaders at the Harvard Medical School-affiliated hospital to spin off the cardiology, cardiac surgery, and vascular surgery departments into a separate business unit, and put him in charge. When he jumped to Caritas a year later, he left behind bitter feelings and resentments.

That move came after he impressed Boston advertising guru Jack Connors during a 90-minute meeting that de la Torre again arranged through a mutual friend.

“I picked up the phone and talked to the archdiocese,’’ Connors, chairman of the rival hospital network Partners HealthCare and a major Catholic benefactor, recalled in an interview.

“I said, ‘I know you’re looking for a CEO and I think you should talk to this guy.’ They said they were already down to three finalists, and I said, ‘That’s your call, but you should consider making it a final four,’ and they did.’’

In April 2008, the archdiocese introduced de la Torre as its new hospital chief executive.

With his compact build and salt-and-pepper hair meticulously trimmed to a crew cut, de la Torre was a bundle of energy — intense, upbeat, and eager to please — as he bounded through his hospitals Friday to promote the deal. Every question from community leaders and employees was a “good question,’’ and no problem was insurmountable. But, in other settings, he can also come off as brusque and impatient, ambitious, and self-confident to a fault, qualities that have rubbed some of those in his path the wrong way.

Born to Cuban immigrant parents who fled the Castro regime in 1960, de la Torre inherited the drive of his father, Angel, a Florida cardiologist. He remembers his father ordering him to work 12 to 16 hours a day as a hospital orderly when he was a teenager.

“I came from a very driven household,’’ he said. “When you woke up on a Saturday morning, there was a list of chores.’’

De la Torre graduated from Duke University in 1988 with an engineering degree, worked briefly as an engineer, and then came to Boston to attend Harvard Medical School and MIT. He trained as a surgeon at Massachusetts General Hospital, abandoning plans to join his father’s practice in Jacksonville, Fla., when he met his wife, Wing, an immigrant from Hong Kong and a fellow doctor in training.

De la Torre took a job at Boston Medical Center as a cardiac surgeon in 1999. But he did not stay long.

Again a mutual friend, Dr. William “Billy’’ Cohn, arranged, in 2000, for de la Torre to talk to Beth Israel Deaconess’ head of cardiothoracic surgery, Dr. Frank Sellke, now at Brown University.

“He got in front of Sellke and said, ‘You guys should hire me’,’’ said Cohn, who is now a cardiac surgeon at The Texas Heart Institute in Houston. “Everyone who met him immediately realized he was a superstar. He was gifted in looking at the landscape and seeing where there is an opportunity and seizing it.’’

At Beth Israel Deaconess, Cohn said, de la Torre quickly built a reputation as a gifted high-volume heart surgeon who could do complex and risky operations through very small incisions, called minimally invasive surgery. “He would at times lament that there had to be an easier way to make a buck,’’ Cohn said.

Within a year, Cohn said, de la Torre had hatched a plan to help them both.

He persuaded Cohn to let him negotiate a contract and raise for the two of them as a package deal, believing that would give them more leverage with hospital administrators. “He took care of it, and my salary went way up,’’ Cohn said.

De la Torre was not driven by money, but by his determination to be the best, his former colleague said. “He used to say, ‘It’s not about the money, but that’s one way people keep score.’ ’’

When de la Torre took the Caritas job, he and Levy seemed to part on good terms — Levy wished de la Torre luck on his blog and de la Torre responded with a warm thank-you signed “Forever Family, Ralph.’’ But word began circulating in the hospital community that the two had a falling out, and that de la Torre was trying to woo Beth Israel Deaconess physicians.

“Once he left, they had skirmishes over doctors,’’ said Thomas Glynn, chief operating officer of Partners HealthCare. “They both had an investment in winning.’’

Neither Levy nor de la Torre will discuss the situation.

Caritas was struggling when de la Torre arrived, and he moved quickly to consolidate operations at the community hospitals. He cut jobs, froze salaries, negotiated higher reimbursement rates from insurers, and recruited specialists to perform more complex — and profitable — procedures such as prostate operations. The chain swung from a $20.5 million loss in fiscal 2008 to operating income of $30.5 million last year. Now consumed with the business side of health care, he let his medical license lapse.

“He was much bolder and more successful than I would have predicted,’’ said Glynn, who regularly meets with de la Torre for a meal to discuss hospital administration.

But the Caritas system also suffered some embarrassing setbacks during de la Torre’s tenure. It abruptly ended a joint venture with a Missouri insurer at the insistence of Cardinal Sean P. O’Malley, who feared it would entangle the hospitals with abortion providers. And a senior executive hired by de la Torre stepped down after Mount Auburn Hospital in Cambridge complained about a threatening voice mail message the Caritas executive left for a Mount Auburn recruiter who was trying to lure away several top Caritas doctors.

Last week, with the promise of a shining new future for the cash-starved system, those setbacks seemed like distant memories. And the recent setbacks of Cerberus itself, including its failed investment in Chrysler, were not mentioned during de la Torre’s tour of his hospitals Friday.

Shortly after 7:30 a.m., de la Torre, sporting a dark suit and red tie, sat in the rear of a black Suburban van driving in the sleet toward Good Samaritan Hospital in Brockton. He fielded a constant stream of calls on his BlackBerry and engaged in serial short conversations, alternating between English and Spanish.

“Hell of a long run for a very short slide,’’ he told one caller.

“You going to buzz by Good Sam?’’ he asked another.

Between calls, he removed a color-coded chart from a folder, detailing what he and other Caritas senior executives would be doing every day for the next two weeks for the Cerberus rollout.

“There’s a lot of misconceptions out there that because I’m Cuban, I’m tempestuous and hot tempered, and because I’m a cardiac surgeon, I’m a shoot-from-the-hip cowboy,’’ he told a reporter riding with him. “The reality is I’m the most obsessive compulsive person you’ll ever meet. I plan and micromanage to a fault.’’

About 8 a.m., the van pulled up in front of the hospital. De la Torre walked briskly into the lobby. “Let’s rock and roll,’’ he told chief operating officer Donna Rubinate.

Employees greeted him enthusiastically as he strode through corridors and offices. “Thank you for saving us,’’ Cathy Hull, an executive administrative assistant, called out as he passed her desk.

At a breakfast meeting of politicians and community leaders, he launched into a stump speech of sorts. “The question was, ‘Can we be who we need to be without capital?’ ’’ he asked rhetorically. “The answer is no.’’

De la Torre said the emergency room is inadequate and money from the sale will pay for a new one, as well as major improvements at the chain’s other hospitals.

“It was simply a deal we couldn’t pass up,’’ he said. “So here we are.’’

When he was finished, the audience erupted into sustained applause. As people came forward to congratulate him, de la Torre beamed.