Turning an idea into a sustained advocacy initiative requires more than identifying an unmet need. For James Caleb Runyon, MSN, NP-C, it has also required patience, collaboration, and a willingness to move forward before every detail was perfect.
In a recent Dermatology Times interview, Runyon reflected on lessons learned while developing his skin cancer awareness work, from conducting an initial survey of hairdressers and barbers to establishing partnerships and educating personal care professionals. He also discussed balancing advocacy with clinical practice and navigating questions surrounding scope of practice.
Starting Before Everything Is Perfect
Runyon’s initiative began with a 25-question survey of hairdressers and barbers assessing their willingness and ability to recognize concerning skin changes. What he did not anticipate was how quickly the idea would attract attention.
Local media began reaching out for interviews, putting Runyon in the position of discussing an initiative that was still evolving.
“If you hold off until it’s perfect, it just wouldn’t happen,” Runyon said.
That experience became an early lesson in allowing an idea to develop publicly rather than waiting for every component to be finalized. From there, he continued creating educational resources and connecting with clinics, programs, and organizations pursuing similar goals.
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Building Partnerships Takes Time
Runyon said time has been one of the most significant challenges of developing the initiative while maintaining his clinical career. Much of the work has taken place during nights, weekends, and days off.
Partnerships have required patience as well. Some collaborations developed over months rather than weeks, including one that took approximately 6 months of conversations before becoming official.
“Great things take time to evolve,” he said. “Patience is a virtue, we all hear it, but experiencing it is really hard, and it’s different.”
For Runyon, learning to work within those timelines has become part of building an initiative designed to extend beyond an individual clinician.
Advocacy Can Be Part of Clinical Practice
Runyon also emphasized that advocacy does not have to exist separately from patient care. His clinical experience helped shape the initiative and continues to inform how he communicates its purpose to other health care professionals.
One of the questions he encounters most frequently—particularly from physicians—is where the role of a personal care professional ends and the role of a clinician begins.
“Awareness is not diagnosis. Observation is not diagnosis,” Runyon said. “Awareness is basically early detection and preventable fatality.”
That distinction has become central to his approach. The initiative does not ask people outside medicine to diagnose skin cancer. Instead, it focuses on helping them feel comfortable recognizing that something appears unusual and encouraging an individual to seek medical evaluation.
Defining a Clear Role Outside the Clinic
That philosophy also shapes how Runyon approaches education for hairdressers, massage therapists, tattoo artists, and other personal care professionals.
Rather than teaching participants to distinguish basal cell carcinoma, squamous cell carcinoma, or melanoma, Runyon focuses on simple observations. Something may look different than it did previously, appear noticeably darker than the surrounding skin, or otherwise stand out.
“I just want them to know that if it’s off or different, that is something worth mentioning,” Runyon said.
Some participants initially expressed concern that they lacked the medical knowledge necessary to take part. Runyon said that expertise is neither expected nor necessary because their responsibility is intentionally limited.
“Their role is basically to observe and encourage follow-up if necessary,” he said.
By clearly defining those boundaries, Runyon has been able to keep the initiative centered on awareness while continuing to build relationships between clinicians and professionals who regularly see areas of the skin that patients themselves may overlook.
