Gov. Bill Haslam (far right) swears in Dr. John Dreyzehner as the Commissioner of the Tennessee Department of Health while his wife, Dr. Jana Dreyzehner, and sons John (far left) and Jason look on proudly.

Dr. John Dreyzehner Takes Top Public Health Spot

Some people set out on a journey with their course completely mapped out. Others take the scenic route, being drawn down different paths along the way.

John Dreyzehner, MD, MPH, FACOEM, readily admits he falls into the latter group … and he wouldn’t have it any other way. After all, it’s his culmination of experiences that helped him arrive in Nashville this fall as the newly-minted Commissioner of the Tennessee Department of Health.

Dreyzehner follows Susan Cooper, RN, MSN, who was appointed by former Gov. Phil Bredesen and agreed to stay on to help with the transition and first legislative session under Gov. Bill Haslam. In announcing Dreyzehner’s appointment on Sept. 2, Haslam said, “I am pleased that John has agreed to join our team. He brings a wealth of experience to the position from his service in the Air Force to his work as a public health official in Southwest Virginia and Northeast Tennessee.”

 Dreyzehner is a Fellow of the American College of Occupational and Environmental Medicine and board certified by the American Board of Preventive Medicine. In addition to his specialty, he has also received training in addiction medicine and is a diplomate of the National Board of Medical Examiners. Dreyzehner is licensed to practice medicine and surgery in both Tennessee and Virginia.

His journey to becoming Tennessee’s top public health official began in the suburbs of Chicago. Growing up in Glenview, Ill., he said there wasn’t a seminal event that steered him toward medicine. “The truth is, I think I was led to it. There’s been a trajectory as I look back over my life that has led me to different things along the way,” he noted, adding that as a spiritual person he has welcomed such guidance.

His father, a Marine, was incredibly mechanical and was a bit of a self-taught engineer who would have welcomed formal training in the field and therefore encouraged his son to pursue that path. “I knew I didn’t have an interest in or aptitude toward engineering,” Dreyzehner recalled. So when it came time to fill in the form declaring a major at the University of Illinois, Champaign-Urbana, he selected pre-med. “That seemed to make everyone happy,” he noted with a laugh. “A lot has followed from that fateful filling in of the bubble.”

Ultimately, that decision led to marriage, two sons, service in the Air Force, specialization in preventive medicine and in occupational and environmental medicine, leadership of health districts, faculty appointments at the university level and now oversight of the quest to improve health in Tennessee.

The evening before beginning medical school at the University of Illinois – Chicago, he met another young student, Jana, who would go on to earn her medical degree in psychiatry. Dreyzehner, who was commissioned as a second lieutenant in the Air Force as he began medical school, completed part of his training at the School of Aerospace Medicine at Brooks AFB in Texas. There, his path first crossed with Royce Moser, Jr., MD, who would play a significant role in his later training. 

He and Jana wed and headed east to Andrews AFB where Dreyzehner completed a transitional internship and Jana finished medical school. The move introduced the couple to the beauty of Virginia. After completing his internship, Dreyzehner worked as a flight surgeon at Langley AFB. “In the Air Force, I really first got introduced to public health,” he said, adding that in his position he found himself involved in disease outbreak investigations, immunization campaigns, disease advisories, and looking into food and environmental issues impacting health.

“My experience in the Air Force and military is fundamental to my training,” Dreyzehner continued. “It taught me about chain of command. It taught me the difference between line and staff … the whole concept of systems and systems thinking and human factors and analysis of root causes when things go wrong.”

Ultimately that love of preventive medicine and public health led him to Salt Lake City in the mid-1990s where he embarked on an occupational medicine residency at the Rocky Mountain Center for Occupational and Environmental Health. There he was reunited with Dr. Moser, who by then led the program. During that time period, Dreyzehner also earned a Master of Public Health from the University of Utah.

When Dreyzehner separated from the military after completing his residency in 1997, he and his wife knew they wanted to come back east to settle with their children. Dreyzehner had done a brief Catholic-based mission in the Virginia Appalachians, and the couple was drawn to that part of the country. They loved the culture, music and family atmosphere, while also recognizing the need for their medical specialties in the area.

“I got hired by a hospital company who happened to have an occupational medicine clinic in Southwest Virginia. Ultimately, we decided on the Virginia side of the Tri-Cities, mostly because it was closer to my job,” he noted, adding that Jana actually began working as a psychiatrist with the Wellmont Health System in Bristol, Tenn. within about six months of their arrival.

After several years in private practice, Dreyzehner made the switch to public health. “There was an opening for a health director that had been open for quite some time but hadn’t caught my eye,” he recalled. “A few folks encouraged me to apply. I really thought about it … prayed about it … and knew that was really, really what I was interested in … that’s what I was passionate about.”

By January 2002, Dreyzehner was the district director for the Cumberland Plateau Health District, where he remained until accepting the role as Commissioner of the Tennessee Department of Health in September. Although he was responsible for the oversight of several counties in Southwest Virginia, he said the geographic proximity included strong collaboration with officials in Northeast Tennessee. “Many of us in that region recognized while the state border was important in many ways, it didn’t impact people’s decisions about where to seek healthcare.” The net effect was that officials on both sides of the border formed strong collegial bonds and worked together on everything from public health media campaigns to pandemic flu summits to continuing education offerings for health professionals.

As for his new role, Dreyzehner said he was extremely honored to have been tapped by the governor to lead Tennessee’s efforts to improve the health status of its citizenry. His experience, he said, gives him a solid framework for the task at hand. “No one has to explain public health to me. I feel fortunate to have worked in state and federal government for most of my career.”

Looking ahead, he said his top two priorities are “the continuous improvement of the Tennessee Department of Health for both internal and external customers and the continuous improvement in the prosperity and health of Tennessee.” Recognizing how other disciplines impact health and wellbeing, Dreyzehner said he is excited to work collaboratively with his new colleagues in the Haslam Cabinet.

“Economic development and job creation are exceptionally important to health. Education is exceptionally important to health. If people don’t have a reason to get out of bed in the morning, it’s difficult to convince them their health is important.”

Equally, he said he plans to continue fostering a collegial relationship between public health and private for-profit and non-profit healthcare entities. Dreyzehner said it takes a team effort to effectively address the significant health issues Tennessee faces including obesity, diabetes, heart disease, prenatal care and infant mortality.

“It’s absolutely critical that we continue to collaborate to move the needle,” Dreyzehner concluded.

Related Story

The Sum Total of His Parts

Dreyzehner Calls on His Varied Experiences to Address Health Issues
By CINDY SANDERS

Everyone’s worldview is impacted by life experiences. Certainly this is true for Tennessee Department of Health Commissioner John Dreyzehner, MD.

Specializing in preventive medicine with experience in occupational medicine, aerospace medicine and public health, he also has training in addiction and has gained additional insight through association with the military and his wife, Jana Dreyzehner, MD, a psychiatrist. Those varied influences are clear when he passionately begins speaking about the issue of obesity and other addictive behaviors.

Most people, he noted, don’t get out of bed in the morning and plan to engage in unhealthy habits. “They want to do well. When things don’t go well, there are typically root factors to that,” Dreyzehner noted.

Some of those factors, he continued, are so deep-seated that it takes incredibly focused attention to sidestep behaviors that have become automatic. Habit pattern interference occurs when a person does something the same way all the time. Even when an event occurs that necessitates a person change their routine, the established habit interferes with their ability to modify their actions.

This example was made crystal clear to Dreyzehner when investigating a plane that had gone down in an uncontrollable spin. The experienced pilot banked the plane just over the limit for the situation though he was aware the plane’s fuel tank had become unbalanced due to a mechanical malfunction. While the pilot logically knew not to exceed a certain degree of bank, habit took over. Dreyzehner said in those cases, it’s necessary to create systems or to have a work-around that prevents a habitual action. For someone who stops at a fast food restaurant five nights a week, the work-around might be as simple as changing the route home in the evening.

Modern humans also must fight the deeply ingrained hunter/gatherer instinct. “We have evolved over millennia to respond to stimuli in a certain way,” Dreyzehner explained. “It’s only in the last 10,000 years that humans can readily control food sources. Until recently, if you didn’t eat heartily when food was plentiful, you wouldn’t survive. The gorgers did better than those who weren’t able to gorge.”

Furthermore, he said we are hard-wired to engage the dopaminergic pleasure center. “Unfortunately, that dopaminergic system can be subverted and encourage us to do things to excess.”

These ingrained factors are exacerbated by the fact that never in the history of our species has the ability to feast been so plentiful. “We have an abundance of calorically dense food,” Dreyzehner said. “We have an abundance of sweetened beverages that provide calories without an adequate stimulus to our satiety center in our brain. In fact, they (sweetened beverages) may encourage us to take in more calories.”

This abundance coupled with lifestyles that do not encourage physical activity has contributed to a significant portion of the American population being classified as overweight or obese. Like any addiction, Dreyzehner said overeating is difficult to control … but not impossible.

“The good news is it’s possible with our ability to understand as individuals and the community’s ability to support and encourage more thoughtful approaches to eating and nutrition that we can turn this around,” he said. “The response has to be multifactorial. There’s not a magic bullet or a quick fix. And the response really has to begin probably pre-developmentally. At the end of the day, we have to take in no more energy than we put out to maintain and take in less to lose.”

He added broader prenatal education could encourage breastfeeding, which evidence has shown lowers the risk of obesity. Dreyzehner said it’s also important to train children to understand their bodies and for adults to model healthy behaviors to ingrain new, better habits for the generations to come.

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