Since the December 5, 2023, Congressional hearing into antisemitic harassment at Penn, Harvard, and MIT, I was shocked to learn how universities, large and small, public and private, have been hijacked by extreme right-wing leaders connected directly or indirectly to the GOP.

Examples include:

Youngstown State University bypassed the normal search process to select its new president, Republican U.S. Representative Bill Johnson. Johnson has no experience in academia and voted with dozens of other GOP lawmakers in their failed effort to block Joe Biden’s 2020 victory.

Kevin Guskiewicz left as chancellor of the University of North Carolina (UNC)-Chapel Hill partly due to political interference from the university’s almost-all-Republican trustees. Guskiewicz was replaced on an interim basis by board trustee Lee Roberts, a former state budget director under a Republican governor. Roberts has a background in finance and real estate, but he has no substantive experience running a large university.

Meanwhile, in a messy and contentious process, UNC-Chapel Hill initially denied and subsequently granted tenure to Nikole Hannah-Jones, one of America’s top Black journalists and a Pulitzer Prize winner for the 1619 Project. Hannah-Jones instead joined the faculty of Howard University.

Florida’s Republican governor and current presidential candidate, Ron DeSantis, elected Ben Sasse, a Republican senator from Nebraska and president of the flagship University of Florida, despite protests related to both the search and Sasse himself.

In addition, DeSantis aims to crush the progressive New College of Florida by appointing Richard Corcoran as interim president. Corcoran is the former Republican Speaker of the House in Florida’s Legislature. The decision to hire him occurred before public comments — virtually all negative — were entertained.

This academic whitewashing and suppression of educational freedom across America is lamentable. Florida is a prime example of a state where a swath of new conservative trustees has been appointed to colleges through political back-channels, arguing that liberal leanings have corrupted the state’s culture.

Columnist Will Bunch remarked, “Controlling [university] campuses — curbing their diversity initiatives and downsizing the liberal arts that promote critical thinking while pumping up pro-capitalism business or STEM courses — helps their real agenda, which is molding young people less likely to challenge their authority. We lose that war when they capture Youngstown State …”

Bunch attributes the Republican blowback to a decades-long emphasis on liberal arts education, beginning after World War II with the GI Bill and piquing in the early 1970s with college protests against the Vietnam War. Ronald Reagan subsequently marshaled a conservative educational agenda, first in California as governor and later as president of the United States, making sure that conservative governors and state legislatures slowed taxpayer aid for universities and boosted tuition — a trend that accelerated dramatically after the Great Recession.

Gradually, over the last decade, liberal university trustees have been ousted in the name of “political correctness” or “wokeness.” Their conservative replacements have thrown their weight around campus and buddied up with influential donors bent on steering universities away from liberal ideas and professors, as UNC did in the case of Hannah-Jones.

For example, University of Pennsylvania alumnus Saul B. Rosenthal, who donated approximately $168,000 in scholarships earmarked for financially burdened business students, sued Penn, alleging that the school instead gave some of those scholarships to aid student-athletes. Well-known billionaire Marc Rowan, who leads Penn’s Wharton business school’s advisory board, has made no secret about his attempts to alter the school’s mission and academic and governance practices, contributing to the recent resignations of Penn president Liz Magill and board chair Scott Bok.

Just when institutions of higher learning seemed to be making strides in diversity, equity, and inclusion (DEI), no sooner were they called to fight for a new kind of diversity: diversity of thought. When the Harvard Institute of Politics removed alum Representative Elise Stefanik (R-N.Y.) from its Senior Advisory Committee in the wake of the January 6 insurrection and her ongoing claims of voter fraud in the 2020 election, Stefanik wrote in a statement: “The decision by Harvard’s administration to cower and cave to the woke left will continue to erode diversity of thought.”

I really think Stefanik had it backward. The only thing that’s really changing in America is the increasingly radical nature of the right-wing anti-intellectual agenda. And a right-wing war against freedom of thought in America is only heating up — it could get a lot worse in 2024 — and it could further erode freedom of thought and expression in medicine.

I say “further” because we have already witnessed a strong backlash against DEI initiatives in medical schools, as well as practice, in the form of wresting medical decision-making away from doctors and patients – for example, decisions related to abortion and gender identity and even medical licensure, considering that physicians who comprise states’ medical licensing boards are typically political (governor) appointees.

There has also been a huge uptick in the number of scholars and physicians who have been sanctioned or have had attempted sanction since 2000. Views surrounding COVID-19 policies and vaccination contributed to most of the actions. Sanction attempts were also in response to teaching practices, scientific inquiry, speech about race, and institutional policies.

Mayo Clinic fired internal medicine physician Steven Weiss after he published a book about his experiences treating patients through the darkest days of the COVID-19 pandemic. Physicians’ rights to free expression have become so encumbered that it has become necessary to propose a model to distinguish between citizen speech, physician speech, and clinical speech to regulate it.

Organizations such as Do No Harm, which ostensibly advocates for patients, continue to file federal civil rights complaints attacking diversity efforts at medical schools and institutions. Their latest report, “The Return of Segregation,” attempts to debunk well-established research showing that matching physician ethnicity and patient demographics leads to better health care outcomes. But the report simply criticizes published studies as opposed to contributing new empirical evidence about outcomes after patients see physicians of the same race.

The report might have had some merit if it were actually true that racial concordance is unimportant and that matching patients and doctors creates a de facto “segregation” of the races. In the same vein, the HBO documentary South to Black Power, featuring the New York Times opinion columnist Charles M. Blow, calls for Black Americans to move to the South to gain political footholds. But, paraphrasing Blow, I do find it inspiring that sparking the conversation about “reverse segregation” could change the power structure in this country.

And that is what must be preserved: the ability to have the conversation.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine.