"Don't be a doctor if you want to help people"

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alex_sanders_123

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According to this argument, becoming a doctor is not a good way to help people:
"Medical schools are over-subscribed, so the counter-factual of declining to apply to medicine is not there being ‘one fewer doctor’, but closer to a minor change in the aggregate supply of medical students, or an even more minor change in their expected quality. The impact of this is far smaller than there being ‘one fewer doctor’."
https://80000hours.org/career-reviews/medical-careers/
The website makes several other strong arguments about why medicine is not a good career to help people.

From my own experience talking to doctors, I gather many (if not most) doctors believe that being a doctor is a great way to help people. I wonder that if doctors did not believe that they chose a good career for helping people, doctors would not enjoy their work as much.

If I don't think becoming a doctor is a good way of helping people, is that a strong reason for me to not become a doctor?

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I disagree with the entire premise this article is working on - that doctor's don't help people because what's the point of treating a person if you're not treating social determinants of health/changing policy/changing the world? Treating a sick patient is still helping a person. Preventative health is still helping a person. Research that translates into clinical applications helps people. Maybe not on the global scale this site is talking about, but that doesn't mean it's not helping.

Particularly, I take issue with the statement that "It is widely accepted that ‘social determinants of health’ (wealth, socio-economic status, sanitation, education, among others) are much more important than the work of the medical profession in keeping people healthy." Yes, social determinants of health are incredibly important and something we need to address. But not all medical problems can be solved by treating social determinants of health. Wealthy, well educated people still get sick and injured. Eliminating inequalities will not eliminate the need to help sick people.
 
Become a family doctor and move to an underserved area, and you'll be a doctor where there would have been one fewer doctor.

But adding on to the above comment, this site oversimplifies in a number of ways. For one, people have individual aptitudes and are likely to be more effective & have more impact in one career than another.
 
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Become a family doctor and move to an underserved area, and you'll be a doctor where there would have been one fewer doctor.

But adding on to the above comment, this site oversimplifies in a number of ways. For one, people have individual aptitudes and are likely to be more effective & have more impact in one career than another.

@mangoangel Those are some good points, but what about the site's argument that because med school is oversubscribed, if you didn't become a doctor someone else would have? Sure you might be a bit of a better doctor than this other person would have, so your patients might be slightly better treated. But that seems like a very small potential impact compared to careers in public health and politics according to the website.

Become a family doctor and move to an underserved area, and you'll be a doctor where there would have been one fewer doctor.

But adding on to the above comment, this site oversimplifies in a number of ways. For one, people have individual aptitudes and are likely to be more effective & have more impact in one career than another.

Being a doctor in an underserved area, according to the sites reasoning, could well mean having a non-trivial amount larger impact than the average doctor would have, as according to the site the average doctor works in an over served area. Also, the site does acknowledge that you should still pursue medicine if you have better "personal fit" with medicine than other careers.
 
Keep in mind the article was written for a U.K. pre-medical audience. The health care system in the U.K. is very different from the one here in the U.S. I certainly believe that this has an effect on the authors perspective.

With that being said, it is not a great article and I disagree with just about everything, especially their cons:

The direct impact of being a doctor is modest, and smaller than ‘conventional wisdom' may suggest.

Depends but I highly disagree. When a surgeon told me my grandpa would survive it was one of the most impactful things for me to hear, and it motivated me to get into medicine.

Although medicine is a respected qualification, it has modest career capital for transitioning into other jobs relative to the amount of time and money it demands. It is also very hard to change careers in medicine after entering a training program for a given specialty.

There are many opportunities that exist for MDs in research, pharmaceutical companies, government, etc. An MD carries training, prestige, and knowledge. The U.K. being smaller and different won't have the same opportunities here in the U.S. but I can see where they are coming from.

Similarly, although doctors enjoy widespread public esteem, they do not have a great platform for advocacy given the costs involved.

Sure, maybe in the U.K. but here in the U.S. physicians have successfully lobbied for important changes in medicine policy (tort reform, etc.). I do believe physicians should advocate harder against the encroachment of mid-levels into every facet of medicine. Yes, they are important, but there does need to be limitations.


@mangoangel Those are some good points, but what about the site's argument that because med school is oversubscribed, if you didn't become a doctor someone else would have? Sure you might be a bit of a better doctor than this other person would have, so your patients might be slightly better treated. But that seems like a very small potential impact compared to careers in public health and politics according to the website.

Of course, medicine is oversubscribed, it is a competitive field in general. So is any other field in medicine. Not everyone becomes a nurse or dentist. The "oversubscription" is what creates medical students who are capable of excelling in medical school. They take only the best applicants with intent not some randoms applying just because.

The article was written by some random dude who looked up some things and has an opinion, with little to no credentials on the matter. He is probably just mad because he didn't get into medical school so this is what he does now.

EDIT: One more point: He mentions giving 10% of your pre-tax salary to AMF to have an impact in another article, but in 2012 U.K. physicians had an average salary of around 70,000 GBP which is 110,600 USD. In the U.S. average salary was much higher, so even with the exchange rate, a U.S. physician donating 10% pre-tax would have a much larger impact than a U.K physician doing the same.

It is apparent the intent of the article is to turn people away from medicine while they are young and get them working earlier instead of wasting their time applying into medicine. Again, not a great article.
 
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I question this author's findings. If he was so confident in his findings (e.g. that "an additional doctor adds four health years" and that doctors accomplish less than "modest donations to effective charities") he should publish his methodology and results in a public health journal.

He also talks about physicians not having "influence." This argument is stupid. Physicians are not congressmen or senators, nor are they lawyers, businessmen, farmers, or teachers (in the sense of teaching K-12). Yet, the author writes that "doctors are much less well represented than many other professions, not only law, politics, and business, but also farming, teaching, and academia." Why is this even a tenable argument? Physicians have tremendous influence in the fields of health care and health policy. Less so in farming or law or teaching. How is this not obvious?

On the point of academia, I feel he doesn't have a good grasp of the role physicians play in biomedical research. Almost every major biomedical discovery with significant translational potential has been led by physicians or teams of physicians (both from the basic science side and clinical trial side), e.g. insulin, statins, and cancer immunotherapy. He pays only passing mention to this fact: "slanting your efforts more towards the promising areas within medicine (biomedical research, health policy work and public health, possibly healthcare management)" while ignoring the impact that physicians already play in those roles in his calculations.

I don't think the author has a good grasp of the role physicians play in health care. It's not worth the read.
 
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He also talks about physicians not having "influence." This argument is stupid. Physicians are not congressmen or senators, nor are they lawyers, businessmen, farmers, or teachers. Yet, the author writes that "doctors are much less well represented than many other professions, not only law, politics, and business, but also farming, teaching, and academia." Why is this even a tenable argument? Physicians have tremendous influence in the field of health care and health policy. Less so in farming or law or teaching -- for obvious reasons.

I definitely agree. Obviously physicians go into medicine to treat disease not to write policy. Although some physicians do become politicians...
(115th Congress)
HouseRalph Abraham(R-LA-05)2014Family Medicine, Veterinarian
SenateJohn Barrasso(R-WY)2007Orthopedic Surgery
HouseAmi Bera(D-CA-07)2012General practice
HouseLarry Bucshon(R-IN-08)2010Thoracic surgery
HouseMichael C. Burgess(R-TX-26)2010OB/GYN
SenateBill Cassidy(R-LA)2014Gastroenterology
HouseScott DesJarlais(R-TN-04)2010General Practice
HouseNeal Dunn(R-FL-02)2016Urology
HouseAndrew P. Harris(R-MD-01)2010Anesthesiology
HouseRoger Marshall(R-KS-01)2016Obstetrician
HouseTom Price(R-GA-06)2004Orthopedic Surgery
HouseDavid "Phil" Roe(R-TN-01)2008OB/GYN
HouseRaul Ruiz(D-CA-36)2012Emergency Medicine
SenateRand Paul(R-KY)2010Ophthalmology
SenateJohn Boozman(R-AR)2010Optometry
HouseMike Simpson(R-ID-2nd)1999Dentist
HouseBrad Wenstrup(R-OH-02)2012Podiatric Medicine

Along with the lobbying groups that exist, I would say physicians have pretty good representation in government.
 
The article was written by some random dude who looked up some things and has an opinion, with little to no credentials on the matter. He is probably just mad because he didn't get into medical school so this is what he does now.

This is maybe a little harsh. I've looked through this website before, and their whole thing is about how can you, as an individual, make the largest impact for humanity? I don't think the article is saying that doctors aren't important, or that it's not a valid career choice that can be fulfilling and make a difference in the lives of a lot of people. IMO what he's saying- in the context of this website's goals- Is that IF your goal is to make the greatest possible impact on as many people's lives as possible, medicine isn't necessarily as good of a choice as you might think. Maybe it comes across as an attack on the medical profession, but I don't think that's the goal. I actually think it's important for everyone considering medicine to realize that doctors are not arbiters of morality and universally making huge positive impacts on the world, to think that is pretty conceited. It's a profession that people choose for a variety of reasons and if your ONLY answer to "why medicine" is a desire to help people it might be worth reevaluating. Like anything else and there are probably a lot of times where you'll be forced to make choices you think are wrong because of procedure, and all the physicians on here talk about spending huge amounts of time doing paperwork. This author is wrong about a lot of things, and they have been pointed out above, but the underlying message isn't one that should be dismissed with so much vigor by all of us just because it's advocating against something that we all view as inherently valuable and important.
 
This is maybe a little harsh. I've looked through this website before, and their whole thing is about how can you, as an individual, make the largest impact for humanity? I don't think the article is saying that doctors aren't important, or that it's not a valid career choice that can be fulfilling and make a difference in the lives of a lot of people. IMO what he's saying- in the context of this website's goals- Is that IF your goal is to make the greatest possible impact on as many people's lives as possible, medicine isn't necessarily as good of a choice as you might think. Maybe it comes across as an attack on the medical profession, but I don't think that's the goal. I actually think it's important for everyone considering medicine to realize that doctors are not arbiters of morality and universally making huge positive impacts on the world, to think that is pretty conceited. It's a profession that people choose for a variety of reasons and if your ONLY answer to "why medicine" is a desire to help people it might be worth reevaluating. Like anything else and there are probably a lot of times where you'll be forced to make choices you think are wrong because of procedure, and all the physicians on here talk about spending huge amounts of time doing paperwork. This author is wrong about a lot of things, and they have been pointed out above, but the underlying message isn't one that should be dismissed with so much vigor by all of us just because it's advocating against something that we all view as inherently valuable and important.

Fair, I was harsh and I agree with your points. But for the people that do honestly have a passion to be a physician because that's how they view themselves helping others, they should not change their minds because of this article, but merely keep it in mind.

I am pretty sure Dr. Paul Farmer went to medical school and his work alone has inspired many a pre-med. His impact on the world has been infinitely important, but you can't compare his accomplishments to another doctor, the impact someone makes is relative and sure it can be quantified, but I am positive that the family medicine doctor who diagnosed a life-threatening illness in time had a great impact on that family.

If people shouldn't have a "why medicine" about helping others or money, what left is there to want to go into medicine? I think dealing with all of the negatives is outweighed by the positive of even the potential to directly, with your own hands (or diagnosis), save a single life. While it is a stretch, that individual could someday become a president or another Dr. Paul Farmer.
 
Do you want to help millions of people? Don't go into medicine, or go into medicine with a plan to be a media star or a government bureaucrat in addition to doing patient care (e.g. surgeon general, director of state or large city dept of health -- often an appointed position for a physician) If you care about individuals and their quality of life and their ability to live their best life and you like science, then medicine might be a fulfilling career. Believe me when I tell you that when I fell and my leg was flopped over at an unnatural angle not as bad as Kevin Ware ( Kevin Ware Suffered Maybe The Most Gruesome Injury In The History Of Televised Sports [WARNING: VERY GROSS]) but bad enough that it was not going to heal properly and I wouldn't walk again normally without surgical intervention, I was damn glad that someone went to medical school and trained in orthopedic trauma and very glad that someone else there in the OR with us was trained as an anthethesiologist and that there were physicians in the emergency department to take a first look at the injury and determine that I didn't need an emergency procedure to save my leg. There is no substitute for a physician when you need trauma surgery or a transplant or a crash c-section.
 
According to this argument, becoming a doctor is not a good way to help people:

https://80000hours.org/career-reviews/medical-careers/
The website makes several other strong arguments about why medicine is not a good career to help people.

From my own experience talking to doctors, I gather many (if not most) doctors believe that being a doctor is a great way to help people. I wonder that if doctors did not believe that they chose a good career for helping people, doctors would not enjoy their work as much.

If I don't think becoming a doctor is a good way of helping people, is that a strong reason for me to not become a doctor?
The author wrote a crap story. Do what you want to do OP, but maybe stop writing crap stories about topics you don’t understand if you happened to be the writer.
 
Do you want to help millions of people? Don't go into medicine, or go into medicine with a plan to be a media star or a government bureaucrat in addition to doing patient care (e.g. surgeon general, director of state or large city dept of health -- often an appointed position for a physician) If you care about individuals and their quality of life and their ability to live their best life and you like science, then medicine might be a fulfilling career. Believe me when I tell you that when I fell and my leg was flopped over at an unnatural angle not as bad as Kevin Ware ( Kevin Ware Suffered Maybe The Most Gruesome Injury In The History Of Televised Sports [WARNING: VERY GROSS]) but bad enough that it was not going to heal properly and I wouldn't walk again normally without surgical intervention, I was damn glad that someone went to medical school and trained in orthopedic trauma and very glad that someone else there in the OR with us was trained as an anthethesiologist and that there were physicians in the emergency department to take a first look at the injury and determine that I didn't need an emergency procedure to save my leg. There is no substitute for a physician when you need trauma surgery or a transplant or a crash c-section.
Yep, all the hippie doula talk gets discarded if an obgyn with a scalpel is the only way your baby survives the next 15 minutes
 
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According to this argument, becoming a doctor is not a good way to help people:

https://80000hours.org/career-reviews/medical-careers/
The website makes several other strong arguments about why medicine is not a good career to help people.

From my own experience talking to doctors, I gather many (if not most) doctors believe that being a doctor is a great way to help people. I wonder that if doctors did not believe that they chose a good career for helping people, doctors would not enjoy their work as much.

If I don't think becoming a doctor is a good way of helping people, is that a strong reason for me to not become a doctor?

That’ll be an interesting plot twist to a medical school interview.

Interviewer: so why do you want to become a doctor?

Pre-med: well I don’t want to help people.
 
Pre-med: well I don’t want to help people.
Do people actually answer with “Because I want to help people”...?

Like...I find I need to tell a story with some background, some narrative, and some career goals (not specialty)....I feel a convincing “Why medicine” answer cannot be a sentence or two...
 
Notice how Author didnt mention NICE, the Natl Institute of Healthcare Excellence which in the UK, says they will spend 30,000 British pounds per quality life year . About $38,000 US. So if your cancer drug costs 100,000 and it only extends your life 24 months over cheaper therapy, you dont get the expensive drug. I'm not sure many advocating govt run healthcare know this. What a young Mom with breast cancer wouldn't give to spend 24 extra months with her family?
 
Keep in mind the article was written for a U.K. pre-medical audience. The health care system in the U.K. is very different from the one here in the U.S. I certainly believe that this has an effect on the authors perspective.

With that being said, it is not a great article and I disagree with just about everything, especially their cons:



Depends but I highly disagree. When a surgeon told me my grandpa would survive it was one of the most impactful things for me to hear, and it motivated me to get into medicine.



There are many opportunities that exist for MDs in research, pharmaceutical companies, government, etc. An MD carries training, prestige, and knowledge. The U.K. being smaller and different won't have the same opportunities here in the U.S. but I can see where they are coming from.



Sure, maybe in the U.K. but here in the U.S. physicians have successfully lobbied for important changes in medicine policy (tort reform, etc.). I do believe physicians should advocate harder against the encroachment of mid-levels into every facet of medicine. Yes, they are important, but there does need to be limitations.




Of course, medicine is oversubscribed, it is a competitive field in general. So is any other field in medicine. Not everyone becomes a nurse or dentist. The "oversubscription" is what creates medical students who are capable of excelling in medical school. They take only the best applicants with intent not some randoms applying just because.

The article was written by some random dude who looked up some things and has an opinion, with little to no credentials on the matter. He is probably just mad because he didn't get into medical school so this is what he does now.

EDIT: One more point: He mentions giving 10% of your pre-tax salary to AMF to have an impact in another article, but in 2012 U.K. physicians had an average salary of around 70,000 GBP which is 110,600 USD. In the U.S. average salary was much higher, so even with the exchange rate, a U.S. physician donating 10% pre-tax would have a much larger impact than a U.K physician doing the same.

It is apparent the intent of the article is to turn people away from medicine while they are young and get them working earlier instead of wasting their time applying into medicine. Again, not a great article.
Sure some of the applicants to med school might be "some randoms applying because." But do you really think that, of the >50% of US med school applicants unable to gain acceptance to a single US med school, the majority of these applicants are just "some randoms applying because". I would posit that a significant number of US applicants denied to all med schools would actually make decent doctors. If that is true, then in gaining admission to med school you are taking their spot, and so your impact on healthcare is probably far smaller than that of "one more doctor in the healthcare system" and if you go into clinical medicine, you only can likely have an impact of slightly better care than the doctor whose spot you took.

This is the argument as to why medicine is usually a low impact career that I don't think anyone has really effectively challenged yet.

Again I'm not saying that doctors don't do an incredibly important job. It's saying that there are a lot of people vying for the job of a doctor. So in becoming a doctor, you aren't adding to the supply of doctors, you are just taking someone else's spot and maybe performing slightly better as a doctor than the applicant whose spot you took would have performed
 
Sure some of the applicants to med school might be "some randoms applying because." But do you really think that, of the >50% of US med school applicants unable to gain acceptance to a single US med school, the majority of these applicants are just "some randoms applying because". I would posit that a significant number of US applicants denied to all med schools would actually make decent doctors. If that is true, then in gaining admission to med school you are taking their spot, and so your impact on healthcare is probably far smaller than that of "one more doctor in the healthcare system" and if you go into clinical medicine, you only can likely have an impact of slightly better care than the doctor whose spot you took.

This is the argument as to why medicine is usually a low impact career that I don't think anyone has really effectively challenged yet.

Again I'm not saying that doctors don't do an incredibly important job. It's saying that there are a lot of people vying for the job of a doctor. So in becoming a doctor, you aren't adding to the supply of doctors, you are just taking someone else's spot and maybe performing slightly better as a doctor than the applicant whose spot you took would have performed
The traditional societal idea of what a doctor does is a role of maintenance and upkeep. A stereotypical doctor does not generally “help” people, they keep the people going. An underlying analogy could be doing routine maintenance on your gas powered car fixes the car or keeps it from breaking, but it is still contributing to climate change.

Individuals within medicine tend to view their future careers as impactful, but more or less the average doc will just be a person mechanic. The potential to do good in medicine, however, through getting involved in policy, humanitarian work, research etc. is limitless - it is just not what society views doctors as doing and not where most doctors end up.
 
If that is true, then in gaining admission to med school you are taking their spot, and so your impact on healthcare is probably far smaller than that of "one more doctor in the healthcare system" and if you go into clinical medicine, you only can likely have an impact of slightly better care than the doctor whose spot you took.

This is the argument as to why medicine is usually a low impact career that I don't think anyone has really effectively challenged yet.

Honestly, this argument doesn't make sense to me at all. The reason why most people are applying to medical school is not to "impact" health care. At the core of most people's pursuit of medicine is some variation on helping people through their role as a care provider. These are not the same thing.

Now, I feel the author is arguing that at a core of a physician's desire to entire medical school is to help the greatest amount of people possible. Some physicians may have this goal. Most do not.

You are also forgetting that the supply and demand constraints you present are also true for almost every other field that allows one to influence health. For instance, there are a limited number of spots in the NIH, in state legislature, in Congress, and in the HHS and so forth in order for one to enact change in health care.

Also consider that many of the ones who do strive to enact change in health care are indeed MDs or DOs -- so what does that tell you about the people applying to medical school?
 
If I don't think becoming a doctor is a good way of helping people, is that a strong reason for me to not become a doctor?
Yes. 100% yes.
No one answered that question, so I figured I would make it blatantly clear.

Also, honestly, you seem to agree so much with the article that you do not care what all of the actual professionals say here, so I am going to keep my comment on the article out of it.
 
Honestly, this argument doesn't make sense to me at all. The reason why most people are applying to medical school is not to "impact" health care. At the core of most people's pursuit of medicine is some variation on helping people through their role as a care provider. These are not the same thing.

Now, I feel the author is arguing that at a core of a physician's desire to entire medical school is to help the greatest amount of people possible. Some physicians may have this goal. Most do not.

You are also forgetting that the supply and demand constraints you present are also true for almost every other field that allows one to influence health. For instance, there are a limited number of spots in the NIH, in state legislature, in Congress, and in the HHS and so forth in order for one to enact change in health care.

Also consider that many of the ones who do strive to enact change in health care are indeed MDs or DOs -- so what does that tell you about the people applying to medical school?

As to your point:
You are also forgetting that the supply and demand constraints you present are also true for almost every other field that allows one to influence health. For instance, there are a limited number of spots in the NIH, in state legislature, in Congress, and in the HHS and so forth in order for one to enact change in health care.
Yes, many other high impact career paths are oversubscribed, but from what I gather reading the author's article is that these other career paths, unlike medicine, are talent constrained. Sure many politicians may be vying for a single spot in the state legislature, but most politicians are not as smart or at least as unselfish as the average medical student who gains acceptance to a med school. Hence, someone who is able to succeed in clinical medicine would have more impact as a politician / congress person / etc.

As to your point:
At the core of most people's pursuit of medicine is some variation on helping people through their role as a care provider.
That may be true. I am not saying that I think that most people pursue medicine in order to have the biggest impact on humanity. However, it does seem like most of the people pursuing medicine do believe that medicine is a fairly good choice of career path toward helping people relative to most other career paths (e.g. finance, software engineering, consulting, etc.) and it is this point, that medicine has an above average impact on humanity compared to other career paths, that I am not so sure about. It seems as though doctors who practice clinical medicine may not have as much impact as they may have had if they pursued other careers like politics, research on critical issues (e.g. nuclear safety research), working for an effective nonprofit in Africa, or even working on Wall Street or doing a tech startup and donating a large portion of their profits etc. Note that I am referring to clinical medicine. MDs or DOs that go into biomedical or healthcare research, politics, administration, etc. probably often times have a lot of positive impact.
 
As to your point:

Yes, many other high impact career paths are oversubscribed, but from what I gather reading the author's article is that these other career paths, unlike medicine, are talent constrained. Sure many politicians may be vying for a single spot in the state legislature, but most politicians are not as smart or at least as unselfish as the average medical student who gains acceptance to a med school. Hence, someone who is able to succeed in clinical medicine would have more impact as a politician / congress person / etc.

As to your point:
That may be true. I am not saying that I think that most people pursue medicine in order to have the biggest impact on humanity. However, it does seem like most of the people pursuing medicine do believe that medicine is a fairly good choice of career path toward helping people relative to most other career paths (e.g. finance, software engineering, consulting, etc.) and it is this point, that medicine has an above average impact on humanity compared to other career paths, that I am not so sure about. It seems as though doctors who practice clinical medicine may not have as much impact as they may have had if they pursued other careers like politics, research on critical issues (e.g. nuclear safety research), working for an effective nonprofit in Africa, or even working on Wall Street or doing a tech startup and donating a large portion of their profits etc. Note that I am referring to clinical medicine. MDs or DOs that go into biomedical or healthcare research, politics, administration, etc. probably often times have a lot of positive impact.
I’m sorry you didn’t get in.
 
As an ED doc I feel grateful that I get to help patients on a regular basis. What that means varies from day to day. Today it was lytics for a stroke, timely neurosurgery consult for a large herniated disk with weakness, and taking care of a little kiddo with epilepsy after a complex seizure. As Lizzy eluded to earlier, I didn't help a village get clean water, but I did make a difference in the lives of these patients and can wake up tomorrow and try again with the next crop. I feel fortunate to have the job that I have and feel good about the profession more often than your average worker.
 
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