From Justice Alitos Dissent:
"Not only is the Court’s decision inconsistent with the underlying theory of Parker; it will create practical prob- lems and is likely to have far-reaching effects on the States’ regulation of professions. As previously noted, state medical and dental boards have been staffed by practitioners since they were first created, and there are obvious advantages to this approach. It is reasonable for States to decide that the individuals best able to regulate technical professions are practitioners with expertise in those very professions. Staffing the State Board of Dental Examiners with certified public accountants would cer- tainly lessen the risk of actions that place the well-being of dentists over those of the public, but this would also com- promise the State’s interest in sensibly regulating a tech- nical profession in which lay people have little expertise.As a result of today’s decision, States may find it neces- sary to change the composition of medical, dental, and other boards, but it is not clear what sort of changes are needed to satisfy the test that the Court now adopts. The Court faults the structure of the North Carolina Board because “active market participants” constitute “a control- ling number of [the] decisionmakers,” ante, at 14, but this test raises many questions."
