I’m not a physician. I want to say upfront that this is just a theory; however, working with physicians and being married to one for twenty-one years has sparked a theory I think is worth bringing up.

I came to these thoughts by helping physicians launch and grow their own independent practices and from co-hosting a podcast with my husband where we spoke to health care workers. On-Call with Dr. Dave was a place to share stories from the front lines. The more guests we talked to, the more often we heard the term “burnout.” And I was alarmed by how many confided in us off-air that they would love to be doing something, anything, else.

But when I talk to my clients who have opened, or are in the process of opening, their own independent practices, burnout doesn’t come up. From what I’ve seen publicly, burnout gets treated as a math problem. Too many hours, too much charting, too many patients in an overloaded schedule. And if you could subtract enough of those numbers, burnout would be a thing of the past. I don’t doubt that reducing the workload contributing to these numbers might be the cure. But it doesn’t fully explain something I keep seeing across specialties.

From where I sit, physicians are the smartest of the smart. The most dedicated of the dedicated. I had a front-row seat to medical school, intern year, residency, and fellowship. Medical training is no joke, and I refuse to believe we’re losing good physicians because they are whining or weak-willed.

Here is my theory: When you take a person who has historically thrived working to achieve a massive goal (probably since they were in middle school), and make them relive the same day over and over again while meeting somebody else’s arbitrary standards, you are taking more away than just their autonomy. You’ve taken their purpose away. That is a lot more than a math problem.

I acknowledge that doctors are not a monolith, and each person’s work capacity is different. What I’m saying is when you place high-achievers in a job requiring the complex problem-solving that they were trained for, and then strip away any sense of the freedom of how they wish to solve that problem, it’s a recipe for frustration.

When I’m working on laying the foundations for a new practice with a physician, they are excited. They come alive! Partly because they are finally able to envision the work environment they’ve always dreamed of, and partly because (I believe) they are taking on a new challenge that is going to affect their life in a measurable way. After they’ve opened and gained some momentum, there is always the option of a new goal to strive for: A new dragon to slay. Honing the patient experience, team building, operations, patient acquisition, leadership skills, or bringing on more talent or partners. Or not. The point is: It’s their choice. My clients and I talk about frustrations around growing, but it’s wrapped in achieving a goal, not exhaustion. I’ve yet to have a conversation where they look utterly defeated.

I don’t think running a business is the answer to burnout, but there is something to be said about a new goal to stretch a person who historically has voluntarily taken on challenges most don’t dare. I’m not here to convince burned-out physicians they should open their own practice. That’s not what this theory is about. It’s about looking at the problem from a new angle. What if subtraction was only half the problem? The other half might just be a new goal to strive for.

Ashley Gay is a medical marketer.ash