In a 6-to-3 ruling, the US Supreme Court struck down the use of race in college administration, effectively gutting affirmative action as a tool for colleges to continue to move toward a fair and equitable educational system, and thumbed its nose at a nation embracing and nurturing a vision of equality and inclusion.

How will this decision impact PAs and nurse practitioners (NPs)? Well, most PAs and NPs are born and built to provide care to populations historically ignored by the medical community. Certainly, many of us have drifted away from primary care to specialties, but even with that, we continue to identify and serve underserved populations — that’s what we do.

NPs and PAs know very well about the impact of bias, discrimination, and racism on our patients. We see it daily and labor to fight against it by providing the best care we can to our deserving patients. We try to steer them from known pockets of prejudice. That’s what we do.

We know the data about the impact of racism and bias in medicine, and we fully understand that race is not the cause of ill health and poor care in American patients, in fact, it is racism. We talk about it amongst our colleagues, we read the literature, and we endeavor to better understand the impacts of bias, both explicit and implicit, on health care and tackle the issue head-on as we care for our patients. That’s what we do.

When the Supreme Court comes down with a decision that completely undermines our work in this arena, it hurts, it stings, and it makes it more difficult to do our work. Today the ruling is about college admissions. Tomorrow it will be about LGBTQ+ rights, which will impact our patients. And the day after that, it will spread its toxic wings to legal, law enforcement, and even NP/PA curriculum. Count on it.

Supreme Court Justice Ketanji Brown Jacksonappeared to be furious about this very scary development on the Supreme Court. Here are some of her comments in her scathing dissent of this tragic decision:

“The best that can be said of the majority’s perspective is that it proceeds (ostrich-like) from the hope that preventing consideration of race will end racism. But if that is its motivation, the majority proceeds in vain.

Gulf-sized race-based gaps exist with respect to the health, wealth, and well-being of American citizens. They were created in the distant past, but have indisputably been passed down to the present day through the generations. Every moment these gaps persist is a moment in which this great country falls short of actualizing one of its foundational principles — the “self-evident” truth that all of us are created equal.”

As NPs and PAs, we have only one choice at this point: to redouble our efforts to identify and address health disparities and the egregious, historic, and ongoing impact of racism on the health of our patients. To educate ourselves and our colleagues about the clear and consistent data about this, and to participate in policy and educational initiatives at the local, regional, and national settings to call out the undeniable continuing presence of race-based prejudice and discrimination impacting our patients.

Justice Brown said it best today in her appropriately angry dissent about the decision:

“With let-them-eat-cake obliviousness, today, the majority pulls the ripcord and announces “colorblindness for all” by legal fiat. But deeming race irrelevant in law does not make it so in life. And having so detached itself from this country’s actual past and present experiences, the Court has now been lured into interfering with the crucial work that [the University of North Carolina] and other institutions of higher learning are doing to solve America’s real-world problems.”