Driving growth with purpose: a conversation with Eqwal CFO (USA), Elton Da Silva

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Elton Da Silva spent nearly 15 years at Ernst & Young before stepping into the corporate world, specialising in IPO preparations and acquisitions for healthcare technology companies among other industries. Now, as CFO of prosthetics provider Eqwal Group in the US, Elton uses his financial expertise to make a real impact on patients’ lives. In this interview, Elton shares how he’s balancing business growth, compliance and patient care, to help Eqwal stay true to its patient-led values.

In exploring the transformation from CFO to CVO, ACCA and BDO consulted nearly 100 finance leaders from across many geographies.

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Hi, Elton. Could you start by telling us a bit about Eqwal?

I've been with Eqwal for 18 months. The company started in France and has since expanded across Europe, New Zealand, the US, and Canada. We specialise in prosthetics, operating in three segments: patient care, digital, and components.

Simply put, if someone undergoes an amputation, we support them by providing a prosthetic limb and assessing their ongoing needs. We handle everything from fabrication to post-surgical care, ensuring a smooth transition. More than 75% of our patients are returning, and some even join us as patient advocates (sales representatives).

Our overall goal is to equip prosthetists with technology that enhances quality of life, and to continue aiding the development of advanced prosthetic care.

As CFO, how do you measure success?

Our success is driven by growth, financial sustainability, and patient impact. Over the past 18 months, we’ve nearly doubled in size, and by the end of this fiscal year, we expect to be three to four times larger than when I joined the company.

A key part of our growth strategy involves acquisitions, many of which are practitioner-owned businesses. When we bring them on board, we retain their trade names to preserve strong community ties and local recognition. Former owners stay on in leadership roles, ensuring continuity and expertise.

Financial sustainability is also crucial. Strong performance, including solid EBITDA, enables us to reinvest in research, innovation, and charitable initiatives.


What would you say are the core values that guide your decision making?

While we are privately backed and investors are naturally involved, for us, patients come first. We want patients to return to us when their devices need replacement, which means providing the best possible care.

Regulatory compliance is another major focus, as our industry is highly regulated. Government insurers, in particular, require more documentation than private ones, making it essential to maintain rigorous standards to ensure smooth operations and continued growth.

How do you ensure alignment between investors, employees, and acquired businesses?

We carefully assess investors to ensure they align with our long-term mission. Many of the businesses we acquire start as small, family-run clinics. We aim to preserve that sense of community, maintaining that “small family culture”, but at scale. A key part of our acquisition strategy is ensuring these businesses remain focused on patient care, which is what made them successful in the first place.

Understanding what motivates employees is also crucial, as regional cultures across the US vary widely. We’ve introduced a “shared success incentive plan”, which is structured so that, as the business grows, employees share in that success. Making sure they see the direct benefits of our expansion keeps them engaged and committed.


What’s most important when assessing an investor?

At this point in the US, we have several strong examples that illustrates effectively how our patient care focus has generated financial impact and created value for investors. That’s a key part of our financial reporting – demonstrating how we’ve achieved our mission while also delivering returns.


Our success is driven by growth, financial sustainability, and patient impact. Over the past 18 months, we’ve nearly doubled in size, and by the end of this fiscal year, we expect to be three to four times larger than when I joined the company.

Elton Da Silva

From a finance perspective, where is most of your time spent as CFO?

Most of my time is dedicated to acquisitions: analysing targets, assessing cultural fit, creating synergies, and integrating new companies. Over the past 18 months, our approach has evolved from a purely growth-focused, quantitative analysis to a more strategic, long-term vision of our ideal targets.

Another key focus is data analytics. Many companies rush to adopt AI without ensuring data quality, but we are refining our Electronic Medical Records to generate standardised, reliable data across all subsidiaries. This isn’t just for financial insights, but also to improve operations. It helps track practitioner time with patients, monitor return visits, and optimise reimbursement and revenue growth.

The third major area is financial reporting. With better data infrastructure, we can analyse revenue trends, shifts in product and payer mix, and even how physician notes impact treatment and billing. Altogether, about 80% of my time is dedicated to these three areas.


How do you help newly acquired companies transition to your digital processes without disrupting patient care?

To streamline patient onboarding, we’re implementing AI-driven tools to assist with consultations, note-taking, and practitioner communication. We’re also introducing 3D scanners to enable 3D printing, which speeds up device production and delivery. 

However, cultural resistance is a factor. Some clinicians are used to manual processes and may not immediately trust digital tools like 3D scanning. Beyond implementing new technology, a key focus is guiding teams through the transition to ensure adoption and trust in these advancements.


And are you involved in that as the CFO?

Yes, absolutely. A big part of my role is ensuring transparency by sharing financial information and key performance indicators (KPIs) with our teams. This helps them see how these changes can improve the quality of treatment and patient outcomes.


What’s a key challenge you’re facing in growing the business right now?

One of my biggest challenges is navigating the complexity of the US reimbursement system. Unlike Europe, where many countries have a standardised reimbursement schedule with government incentives, the US has thousands of different fee schedules, each with its own requirements and approval processes. This makes compliance and reimbursement more complex and requires careful financial management to ensure stability and growth.

Despite these challenges, we remain one of the top EBITDA performers in our group. Balancing growth while maintaining strong financial performance is key, as it allows us to reinvest in the business, support acquisitions, and continue expanding our market presence.


Patient impact is the core driver of our business. Even when hiring, we emphasise our mission, helping employees see that they can achieve their personal and financial goals while being part of something bigger. Many of our team members have stayed with us for years because they believe in what we’re building.
Elton Da Silva

How are ESG sustainability considerations impacting you?

While environmental impact isn’t a major factor for us, we’ve started mapping and tracking key data points for ESG disclosures, particularly in France, where regulations are stricter. Our primary focus is on inclusiveness, diversity, and patient data protection. For example, we have strict protocols for handling printed patient information, ensuring secure disposal through specialised vendors to prevent data exposure. 

From a social point of view, our commitment to community impact is deeply embedded in our business. We bring together practitioners, local communities, suppliers, physicians, and amputees to find the best solutions for patients. We have a charitable foundation that runs programmes throughout the year, including an initiative where our practitioners travel to less developed countries to treat patients without healthcare access. They bring components with them, produce prosthetics locally, and stay for weeks at a time to provide care.


So, to summarise, would you say your focus on patient impact is at the heart of the business’s success?

Absolutely. Patient impact is the core driver of our business. Even when hiring, we emphasise our mission, helping employees see that they can achieve their personal and financial goals while being part of something bigger. Many of our team members have stayed with us for years because they believe in what we’re building.

The CFO is no longer just a steward of financial performance — they are becoming architects of long-term, sustainable value. At BDO, we are proud to launch Phase 2 of our CFO to CVO journey, featuring case studies built from interviews with global CFOs leading this transformation.

Browse the interviews below to learn more.

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