Beyond the Clinic: Turning Your Clinical Ideas Into Something Bigger

NPs and PAs are uniquely positioned to recognize gaps in patient education, access, and care. Sometimes those observations stay in the exam room. Other times, they can become the beginning of something much bigger.

J. Caleb Runyon, NP-C, is a nurse practitioner at Bradley Free Clinic in Roanoke, Virginia, and founder of The Closer Look Project LLC. Through The Closer Look Project, Runyon works to expand skin cancer awareness by educating personal care professionals, including hairdressers, barbers, and nail technicians, on recognizing potential warning signs and encouraging clients to seek professional evaluation.

His experience also illustrates a broader opportunity for NPs and PAs: Building something outside the clinic does not necessarily mean leaving clinical practice behind. Sometimes, it starts with simply deciding an idea is worth exploring.

When an Idea Keeps Coming Back

Some of the most meaningful ideas in health care begin with something clinicians repeatedly encounter in practice.

For close to a year, Runyon noticed a pattern among his patients: Many said a hairdresser had been the person to notice something concerning and encourage them to schedule an appointment. Frequently, what had been spotted turned out to be precancerous or worse.

The observation had a personal connection. Runyon's mother has worked as a hairdresser for more than 20 years, and he grew up hearing about the things she noticed from her chair that clients might not otherwise think to bring up with a health care professional.

Still, the idea of doing something with that connection remained just that—an idea.

Then, in February 2025, Runyon's 76-year-old grandfather, who lives in rural West Virginia, was diagnosed with stage 4 metastatic melanoma.

His grandfather rarely visited physicians, Runyon explained, but never missed his monthly trip to the barber.

The experience crystallized something Runyon had been considering for months: In some communities, the people with the most consistent access to individuals may not be health care professionals. Hairdressers, barbers, nail technicians, and other personal care professionals see their clients regularly and may notice a spot on someone's scalp or a changing lesion on their neck long before that person seeks medical care.

How The Closer Look Project Started

That realization became the foundation for The Closer Look Project, which Runyon established as an LLC.

The project focuses on training personal care professionals to recognize potential warning signs of skin cancer and understand when to encourage a client to seek professional evaluation—without asking them to diagnose a condition or step beyond the boundaries of their role.

What began as a personal response to an unmet need has since expanded into workshops, community partnerships, free educational resources, and ongoing collaborations.

Runyon has done it while continuing to see patients.

That distinction is important for clinicians who have an idea of their own but assume pursuing it would require a major career change. Starting a project does not necessarily mean walking away from clinical practice or immediately building a large organization.

It can begin on the side, with one problem and one attempt to address it.

You Don't Have to Quit Your Day Job

For NPs and PAs considering an idea outside their traditional clinical responsibilities, the prospect of starting something can quickly become overwhelming.

There is the name, the business structure, funding, branding, legal considerations, and the question of how to find time for any of it while maintaining a clinical career.

But those pieces do not all need to happen at once.

A clinician interested in patient education, for example, could begin with a single educational session. Someone who sees a recurring knowledge gap could create a 1-page resource and share it with a small group. An NP or PA considering a larger community initiative could survey colleagues or potential participants to determine whether others recognize the same need.

Starting small provides an opportunity to test the idea before investing significant time or resources into building it.

More importantly, it gets the idea out of your head and in front of the people it is intended to help.

LLC or Nonprofit? Start With Your Goal

If an idea does begin gaining momentum, clinicians may eventually need to determine what structure makes sense for the work.

Runyon recommends starting with the project's purpose rather than getting caught up in the label.

An LLC or other applicable business structure may make sense for clinicians interested in areas such as consulting, speaking, professional education, or courses. A nonprofit structure may be more appropriate when the primary goal involves charitable programming, community outreach, grants, or other mission-driven initiatives.

Neither structure is inherently better. The right fit depends on what the clinician hopes to accomplish and how the project may develop over time.

Requirements can also vary depending on location, employer policies, scope of practice, and the services involved. Clinicians considering formally establishing a business or organization should review applicable requirements and seek appropriate professional guidance when needed.

The administrative side should provide a framework for the idea—not prevent the idea from ever getting started.

Start Small, Then Pay Attention

Runyon's advice for clinicians at the beginning of the process is straightforward: You do not need a fully formed vision before taking the first step.

Try the smallest workable version of the idea and see what happens.

Host the educational session. Share the resource. Talk to colleagues. Ask the community you hope to serve what it actually needs.

Then listen to the response.

Are people engaging with it? Are they asking for more information? Does someone want to share the resource with others? Is another organization interested in collaborating?

Those early reactions can help determine whether an idea needs to change, grow, or move in an entirely different direction.

Progress does not have to mean launching a polished organization overnight. Often, it comes from doing small things consistently and allowing the project to evolve in response to the people it serves.

Lessons From Building Something Yourself

Clinicians who decide to pursue an outside project should also understand the boundaries surrounding their work.

That includes reviewing employer policies regarding outside professional activities, understanding relevant scope-of-practice requirements, and keeping business and personal finances separate when money becomes involved.

Runyon also recommends finding other NPs and PAs who have already taken a similar path.

Clinicians are building educational platforms, consulting businesses, community initiatives, nonprofit organizations, and other projects across health care. Professional organizations, conferences, LinkedIn, and existing clinical networks can provide opportunities to learn from people who have already navigated some of the challenges that come with getting started.

And success does not have to mean reaching thousands of people.

The first successful workshop matters. So does the first person who uses a resource, the first organization that wants to collaborate, or the first person who says an initiative helped them recognize something they otherwise might have missed.

For clinicians working in education or community engagement, Runyon also encourages prioritizing usefulness and trust before focusing on monetization.

Provide value first. The opportunities that follow will have a stronger foundation because of it.

Taking Your Impact Beyond the Clinic

One of the biggest opportunities in building something outside traditional clinical practice is the ability to extend the reach of expertise NPs and PAs already possess.

A clinician may only see a certain number of patients in a given day, but an educational resource can continue reaching people between visits. A workshop can put clinical knowledge into the hands of people who interact with populations that rarely seek care. A community initiative can bring dermatologic education somewhere it previously did not exist.

The Closer Look Project gave Runyon another avenue to use the knowledge and communication skills he had already developed as a clinician.

Other NPs and PAs may find their own version of that opportunity in entirely different places.

The starting point is paying attention to the problems that keep appearing.

What Is Your Next Move?

NPs and PAs already possess many of the skills needed to turn an observation into something actionable. They identify problems, translate complicated information, educate patients, adapt when something is not working, and build trust.

An idea outside the clinic uses many of those same skills.

If there is a problem you repeatedly encounter or an idea that keeps coming back, the next step does not have to be launching a company.

Write the idea down in 2 sentences. Ask colleagues whether they are seeing the same thing. Create the resource you wish existed. Talk to someone who has already built something similar.

You do not need to know exactly what the idea will become before you begin.

For Runyon, an observation about hairdressers noticing suspicious lesions eventually became an initiative designed to put skin cancer education into the hands of professionals who may see people long before they enter a dermatology clinic.

The idea you keep coming back to may look completely different.

But it may be worth finding out where it can go.

References

1. Runyon JC. Your patients, your community, your impact: why more dermatology providers are reaching beyond the clinic and how you can too. J Clin Aesthet Dermatol. 2026;19(7–8 Suppl 1). Accessed September 1, 2026. https://jcadonline.com/your-patients-your-community-your-impact-why-more-dermatology-providers-are-reaching-beyond-the-clinic-and-how-you-can-too/
2. O’Reilly-Jacob M, Rambur B, McMichael BJ, Perloff J. Nurse practitioner entrepreneurs—an untapped primary care lifeline. JAMA Health Forum. 2026;7(1):e256200. doi:10.1001/jamahealthforum.2025.6200.