With CCI, When Patients Own Their Care, Everyone Wins
- Teresa Dougherty
- 9 hours ago
- 3 min read
"Go to the people. Live with them. Learn from them. Love them. Start with what they know. Build with what they have. But with the best leaders, when the work is done, the task accomplished, the people will say 'We have done this ourselves.'" —Lao Tzu
Jeremy Howe, family medicine physician and former Associate Medical Director at One World Community Health Centers in Omaha, has long admired Tzu's thinking. Arriving in the Dominican Republic last January under the Chronic Care International (CCI) umbrella, that admiration turned into orientation. As he put it, Tzu's words "became my North Star for the work I set out to do."
Dr. Howe's path from family medicine into clinical leadership wasn't an accident; it grew directly out of his training in public health. While medical school teaches you to treat one patient at a time, public health teaches you to see the whole system: how a hospital or clinic actually functions, where things can break down, and how social factors affect patients' health. Small changes in structure, in turn, can impact patients, families, and communities in underserved corners of the world.
That's the lens through which Dr. Howe views his work in the DR and in the Philippines today.
Dr. Howe and his wife, Kim, a facilitator, coach, and consultant for organizations, have been "friends of CCI" for a number of years, helping with training, team management, and organizational development. For years, Dr. Howe worked virtually with teams in both the DR and the Philippines before traveling to CCI's two clinics in the DR this past January, and again in May, spending several weeks helping local health providers improve operations, workflow, and clinic efficiency.
"The goal is self-directed autonomy," he says. "We want patients to own their healthcare — to lean on each other, to have a more active role in their treatment.”
The couple has also traveled with CCI to the Philippines, helping roll out CCI's disease care model — testing, medication, education, and nutrition guidance for patients living with diabetes and high blood pressure. The model, which also aims to help patients build relationships with community support networks, is taking hold in clinics in both countries, though this effort unfolds differently in each country, shaped by local culture, context, and engagement.
A Store of the People
When Kim joined her husband on his May trip, she expected to spend her time creating support forms, preparing staff materials, and helping organize patient care services. But it quickly became clear that her teamwork and coaching skills were better suited to supporting the patients running the clinic's two colmados (neighborhood grocery
stores). With the involvement of business school students from Creighton University, the colmados — which sell everything from local grocery items to reading glasses, pillboxes, and other everyday essentials — are a way for patients to volunteer their time and help subsidize their care at the clinics.
“The colmados are more than stores," says Dr. Howe. "They're proof of what happens when CCI, the healthcare team, and patients work together to make self-sufficient care possible."
What's more, under Kim’s guidance, volunteer patients are learning leadership skills, business acumen, and financial management, while the community is getting an investment in self-sustenance.
"This is the promise that drew me to CCI," says Kim. "Patients have ownership in bettering their health and their communities. CCI is more than a resource — patients are invested in their own success, and when people have ownership, they have power."
While that power continues to grow, there is more to do. By next spring, the goal is for patients at CCI's DR clinics to reach financial independence, covering the cost of their own care. But financial independence doesn't mean CCI steps back — we'll still be there providing medication, staffing, and the resources patients need to thrive. Your support makes all of it possible. Ninety-two percent of donations go directly toward funding programs in the DR and the other countries we serve.
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