Cayuga Climbs Founder and Owner – Keith Rosenliao

This week’s spotlight is on Keith Rosenliao, a PT who is the founder and owner of Cayuga Climbs, a climbing gym in Ithaca, NY! We offer an exclusive long-form Non-Clinical Deep Dive interview with Keith about MBA careers as a bonus in Non-Clinical 101!

What is your full name, title, and company name for your current, primary role?

Keith Rosenliao, PT, DPT, MBA – Founder and Owner of Cayuga Climbs

What additional roles do you currently have?

I’m the CEO of Aedify, Inc, formerly known as Code from Zero. I’m also doing part-time consulting as a contractor for Potrero Group, mostly helping public lands non-profit partners with strategic planning.

Where are you located?

Fort Benning, GA

Where did you go to PT school, and what year did you graduate?

I went to MGH Institute of Health Professions and graduated in Jan 2014

What did you do when you first finished school, and for how long?

MGH has a year-long (paid) internship that started Sep, 2013 and ended Sept, 2014. We officially graduated in Jan, 2014, but I was already at my paid internship site. I did this internship at Spaulding Sandwich Outpatient (Cape Cod).

After Sept 2014, I became a traveling PT for about two years.

In what setting(s) did you work, and what types of patients did you treat?

I mostly worked in hospital-based outpatient ortho clinics (~2.5 years), but I took one contract to work home health in California for about five months.

My last month as a PT was spent working per diem in a long-term acute care facility in Florida, where we had a lot of patients on ventilators (pre-COVID).

What did you enjoy about your early roles? What didn’t you enjoy?

I generally enjoyed hospital-based outpatient ortho because I had plenty of time to see patients, and there was little to no financial pressure to pack my schedule. This allowed me to focus on just getting the patient better. I mostly preferred non-surgical cases, as I felt surgical protocols were quite restrictive and allowed me less freedom to practice clinically.

With home health, I enjoyed being able to drive around and get to know the area, the freedom of being able to make my own schedule, and having driving time to recharge mentally between patients in the car. It was also fun to just see random people’s houses! The less enjoyable parts were the dirty/insect ridden houses some people lived in, the potential danger (unstable patients with weapons), and the less able patients where just sitting them up unsupported was considered treatment.

My long-term acute care experience was my last stint as a PT. I took a per diem job at an LTAC after I was accepted into my MBA program, but before the program started. I took this job mostly due to its flexibility and pay as a per diem. Generally, not for me, although I learned a lot about respiratory therapy, and the staff were great.

What else have you done since then, prior to your current role?

Since then, I went to Cornell University to get my MBA from 2017 to 2019. During my MBA, I interned (every MBA has a paid, 3-month summer internship) with the National Park Service’s internal business consulting team.

After I graduated, I took a job as a consultant with Booz Allen Hamilton, in Denver. I worked there for two years, with mostly the National Park Service as my client. I consulted on a lot of random things, but one of the more memorable projects I was on was advising the NPS on how to select and prioritize projects for the $9B in federal funding under the Great American Outdoors Act.

When and why did you decide to do something non-clinical?

I had always intended to open my own physical therapy practice, as I have a business-oriented mindset. One reason I became a traveling physical therapist was to see more of the country so I could decide where to settle down and open a clinic. However, after traveling for almost two years, I became a little jaded with the healthcare system. I saw problems with the system that were consistent no matter where I went.

I also gained experience clinically and started to feel a little bored, so looked into what I could do next. One option I considered was to get my OCS, which was something that always interested me. However, an OCS is expensive and time consuming, and it barely affects how much a PT gets paid, or how much insurance reimburses a PT. I also wasn’t convinced it would lead to better patient outcomes. I’m not stating this to be true or no; it’s just my own lack of belief in it.

I looked into opening a clinic, but with low insurance reimbursements and the future for reimbursements looking even worse, I did not feel the stress and work to put into opening a clinic to be worth it. I don’t want to have to structure my clinic in a way that I feel would affect patient care, and I want to see patients one-on-one with enough time. A cash-only clinic was an option that I didn’t want to pursue.

I’m an extroverted introvert in that I enjoy meeting and talking to people, but I need time to recharge. Working with patients all day, back-to-back, was exhausting for me mentally. PT is also relatively physical (even outpatient ortho) and I couldn’t imagine myself doing the same physical treatments in 20 years.

I started looking into an MBA to either pivot my career, or change my career. I figured that I could have a greater chance of improving the healthcare system if I learned more about the business side of it, or joined it and became a leader in it. The MBA also appealed to me because it would expose me to a completely different world.

What are you doing these days?

These days, I do multiple things! First, I ended up focusing on sustainability during my MBA, and consulted for the National Park Service, rather than healthcare. Ultimately, I wasn’t too interested in healthcare administration in a hospital, and most MBA healthcare jobs are more pharmaceutical or biotech focused, neither of which I’m particularly interested in. However, I did take additional classes with the Masters in Health Administration program during my MBA, and I thought those classes were fantastic. I enjoyed working with classmates who would become healthcare administrators and seeing things from their perspective.

While I was still working at Booz Allen, I started a company to teach data analytics to business professionals. When I first got my job at Booz Allen, I found that the MBA curriculum doesn’t cover practical data analytics. Since it was a very useful skill to have as a consultant, I wanted to cover this gap in education. We have taught over 50 classes online. Currently, we teach an annual weekend class with Cornell’s Masters in Health Administration program, along with occasional online classes.

My girlfriend at that time was studying veterinary medicine at Cornell in Ithaca and with COVID, Booz Allen moved to teleworking, so I moved back to Ithaca to be with her. There was no commercial climbing gym in Ithaca (only Cornell, which can be difficult to access) and being a big climber, I wanted someplace to climb.

I decided to open my own climbing gym in Ithaca. The gym has been open for almost two years now and this is my primary occupation. My then girlfriend and now wife, Beth, is a military veterinarian, so we recently got orders to be stationed away from Ithaca, in Georgia. We moved away from Ithaca in July 2022 and I manage the gym remotely. I have been lucky enough to find an excellent local general manager who does the in-person gym management, and I provide the administrative and business support remotely.

With my data analytics education company, we’re also starting to develop a second product. Our second product is a video game that teaches personal finance. Personal finance is a topic that I have always been interested in, and as a physical therapist, I found that finding unique ways to educate patients was one of the best skills I developed.

The point of the video game is to make learning personal finance topics fun. Our goal is to make a game where players learn real world personal finance concepts that they can apply to their own life to make better financial decisions.

Lastly, I started a side business to provide MBA admissions consulting for physical therapists. PTs are smart and know how to work with clients; this is a great combination to have in the business world. However, we know nothing about MBA and the business world. My goal is to first help PTs determine if an MBA is right for them (just like a PT determines if physical therapy is appropriate for a patient), and then if so, help PTs navigate the admissions process so they are not at an disadvantage versus people who are already in the business world.

When I applied to my MBA, I applied to 10 programs outright and was rejected by every single one. Getting into PT school is very different than getting into an MBA program and admissions criteria are very different between the two. This is a passion project on my part so I can help PTs avoid the same mistakes I made.

If you’re a Non-Clinical 101 student, check out our hour-long Non-Clinical Deep Dive bonus video with Keith, where we discuss the ins and outs of MBAs…

Are you still treating patients, or are you solely non-clinical?

I am currently non-clinical, although one day, I may start and manage a PT clinic at my climbing gym (as a manager; still a non-clinical PT). Once we have a more permanent duty station in the Army, I may open a boutique PT practice where I can treat patients one-on-one on my terms, for fun.

Did you get any special certifications or training along the way to help you get into your current role?

Just the MBA, but reading articles and spotlights on The Non-Clinical PT was very inspiring, and it certainly helped me get into the non-clinical mindset!

We offer an exclusive long-form Non-Clinical Deep Dive interview with Keith about MBA careers as a bonus in Non-Clinical 101!

How have people reacted to you leaving patient care?

Some PTs ask me if I feel like I wasted my time or money training to be a PT, while others are very interested and tell me that they would like a way out of clinical practice themselves!

What’s a typical day or week in the life like for you?

I don’t have a typical day, but usually, in the mornings, I do bookkeeping, social media, and other administrative work on the gym. I’m often replying to emails from customers throughout the day.

I also text my staff regarding random gym things. Then, I try to spend a few hours developing the personal finance game myself and looking for and meeting angel investors to fund game development.

What are some of the rewards of your role? What are the biggest challenges?

The traditional MBA path is to be a consultant for a few years and then take a corporate job and rise up the ranks. I started out on the traditional path by being a consultant, but did not want to climb the corporate ladder.

Getting the MBA has opened up the world for me; I have met so many different people and been exposed to so many different industries and things that I never even thought of as a PT.

Even if I didn’t do a single thing with my MBA, meeting my wife through it would have been worth it! 🙂

The biggest challenge for me was getting over the fact that I’m not practicing clinically anymore, despite all the hard work studying to be a PT or the fact that I do like practicing clinically in general. I have now come to terms with this, and I view myself as a PT who is utilizing PT-related skills to help others, just in a non-clinical sense.

Another big challenge was understanding the business world. With the PT world, things are relatively straightforward and PTs are mostly straightforward and honest. With the business world, it is not always like that, and soft skills and networking are more important than academics.

How did your clinical background prepare you for this role? Which skills transferred?

With my education company, I feel that working with patients and educating them was a very transferable skill to developing educational products. As a PT, we tailor the way we motivate patients and the way we educate patients based on each individual personality; I really get into the mindset of each patient to understand their unique motivations. With my education company, we’re creating education products that maximize learning in creative ways, in ways that people enjoy and can relate to.

With consulting and my MBA in general, working with patients to help them solve a problem transferred very well to working with business clients to help them solve a business problem. The soft people skills of working with clients and patients are very similar. (A caveat: As a PT, I was much more firm with making certain patients do things whereas business clients require a bit more of a gentle touch!)

Roughly speaking, how are the hours and pay compared to patient care?

Much, much better. A traditional MBA job can be very high in hours (60+ hours a week) but now, I work for myself and I work when I want. I may send an email to a customer at 10pm at night, but that’s because I want to, not because I have to.

The biggest benefit for me (an extroverted introvert) is that while I enjoyed treating patients, seeing patients back-to-back eight hours a day was exhausting for me. Now, I may have meetings and may be talking to people, but I have a lot of remote work and work from home alone that allows me to split time between being social and “on” and concentrating on work by myself at home.

Honestly, I was quite happy and fortunate that I was no longer practically clinically when COVID came. I can’t imagine what PTs and healthcare workers have had to deal with.

What type of person do you think would do well in your role?

In my role as a business owner, I think a person who enjoys ambiguity in work schedule and a less structured environment would do well. I love that I can work on my own projects and I generally don’t have an issue staying busying or being productive because it is work that I enjoy.

I’m not saying that every PT should get an MBA, but PTs who are interested in the business world should look into getting one. With the right decisions, any PT can succeed in the business world.

Simply put, the academic rigors of an MBA are nothing compared to PT school, and PTs already have great social skills due to working with patients.

Does your organization hire PT, OT, or SLP professionals into non-clinical roles? If so, what type of roles?

Not currently, but in any of my companies, if the need arises, I will certainly hire a PT for a non-clinical role! I can mentor and teach the PT 🙂

What is a typical career path for someone with the type of MBA you got?

The typical MBA path is:

• Consultant for 2-3 years (~$180k annual salary)
• Exit to corporate job (~$200k to $250k annual salary)
• Climb the ladder there

There are some other paths such as leadership rotational programs (~$125k annual salary) or investment banking ($300k annual salary but 100-hr work weeks), but I’d say consulting is a very typical one.

What is next for you? What are your high-level career aspirations?

My priority right now is to continue to grow my climbing gym and develop the personal finance video game. The personal finance video game has huge potential, and I see myself as the CEO of a large educational video game development company one day.

What would you like to change most in your profession, and why? How would you propose doing so?

I would like to see more PTs and clinical healthcare providers have the opportunity to join the business world. Clinical skills are looked down upon in the corporate world, and we can change this.

What would you teach to today’s graduate students in your profession, if you had the opportunity?

An MBA isn’t necessarily necessary or appropriate for everyone’s career goals. But, for those who want to pursue additional education to open up career and financial opportunities within healthcare and beyond, it’s an excellent choice!

Your career story can still be written! Learn what’s out there, which careers suit you best, and how to get there, with Non-Clinical 101!