Friday Shorts: Student loan defaults, robotic surgery, and home cervical cancer screening
June 6, 2025
Shorts and Follow Ups
A. Over 2 million have credit downgraded due to student loan defaults
The New York Federal Reserve reported that 2.2 million Americans had their credit score drop by 100 points or more due to student loan delinquency in the first three months of 2025. Of these, a million Americans had their credit scores decline by 150 points or more. Here’s a link to a past post on what employers are doing to help their employees maintain financial security as they begin student loan repayment.
B. Robot-assisted surgery increases complications
A report in JAMA Surgery using claims data from the Marketscan database, evaluated results of over 800,000 gallbladder surgical procedures performed on adults either laparoscopically or via robot assisted surgery from 2016 to 2021. Robot assisted surgery represented a small but growing minority of all procedures during this time period. They found that patients having robot assisted surgery were 57% more likely to have a post-operative complication and 66% more likely to need a postoperative drain, although they were 53% less likely to have a surgical site infection. The researchers did statistical adjustment to make the groups as similar as possible.
It’s not surprising to find a higher rate of complications when surgeons have just started using a new technology. In fact, gallbladder removals were done with an open procedure (and often a 10-day hospital stay) when I did my training, and at that time laparoscopic surgery was shown to be more dangerous than conventional procedures in some studies. I suspect that robotic surgery will improve over time.
Patients getting newer procedures generally benefit from going to a high volume center where surgeons already have substantial experience. Centers of excellence can improve the quality and cost of surgical care.
C. Validation of at-home cervical cancer test
The Food and Drug Administration approved a cervical swab for cervical cancer screening last year for use only in a provider’s office. A new study published in JAMA Network Open shows that 599 women who swabbed themselves had results that were equivalent to clinician swabs done at the same visit. Making cancer screening easy will improve screening rates, so hopefully the FDA will approve the test for home-use soon.