UP CLOSE AND PERSONAL: A veteran Charlotte doctor bucks the trend toward corporate medical practices.

• Author: Martin, Edward

Why, he gently chides her, did you wait so long to come in? The woman gazes sternly at the young Charlotte doctor. "To be honest," the patient says, "I don't want to see you, but since I'm here, I guess I'll go ahead."

Through the birth of her two children and death of her first husband, the doctor's predecessor had been like family. But that doctor had retired, and she'd let her blood-pressure medicine lapse.

It was the 1980s and her new doctor had recently earned an internal medicine degree from East Carolina University's Brody School of Medicine. His emphasis was on primary care, the front lines of health care and preventive medicine such as controlling hypertension.

Dr. John Sensenbrenner grew up in Union County and earned a bachelor's degree at Lenoir-Rhyne University. He has the persona of a pastor - understandable, considering his Lutheran conviction that medicine is a religious calling. His given names, John and William, were also those of his family doctor, only one of two in the county at the time, who had delivered him and cared for him until he entered college.

The doctor's patient, Carolyn Dunn, is 82 now. She still drives nearly 30 miles through Charlotte traffic as she has done for years, past scores of other physicians' offices, to see Sensenbrenner. "Friends ask me why," she says. "Well, he's like family."

In the airy waiting room, the receptionist greeted her by her first name. During an exam, she playfully patted her stomach and asked the doctor, "Is this fat?"

More than 35 years after they first met, Sensenbrenner, 65, looked up from her chart. With characteristic candor he turned up his mustache at the corners in a smile. "Yes," he nods. "I got the message," says Dunn, who wouldn't have medicine any other way.

Sensenbrenner and his primary care clinic are outliers in today's health care. In 2004, he rebelled, dismayed at what he says was the shifting focus of the hospital-owned clinic where he was employed "from quality care to the bottom line."

He chose to practice medicine alone, in the shadow of giants. Eighty percent of his patients followed, and his independent business now counts 5,000 people on the rolls.

In 2021, the American Medical Association says more doctors were employed by large health care organizations, including private-equity firms, than practiced independently. The AM A says the split is 51% vs 48%, though some experts say corporate ownership is actually much higher.

"It's been 10 years at least since solo or partner practices became the minority, and I expect that's a much smaller minority now," says Tom Ricketts III, a professor and senior researcher at UNC Chapel Hill's Cecil Sheps Center for Health Services.

An estimated 17,000 doctors work for hospitals in North Carolina. Large health systems insist the arrangement...