This is the Elon Musk Podcast, your daily hit of what is really
going on at Tesla, SpaceX, XAI, and the rest of the Musk
universe. I'm your host Will Walden, and I
have covered Elon Musk for more than five years, spent a year on
the ground at SpaceX, Starbase during early Starship
development. And before this, I spent my
career as a software developer working with billion dollar
companies. I've also built and sold my own
businesses. And now I make content and help
other people grow their companies.
And on this show, I use that experience to break down the
news, filter out all the noise, and give you clear context you
can actually use. Recently, Elon Musk has laid out
a concrete goal for the companies Optimist Robot.
He says Optimist could one day perform surgery with high skill,
giving every patient access to top tier care.
And of course, that is if they could pay for it.
He links that vision to a broader shift to test the toward
technology that reaches into daily life.
And he points out that a shortage of skilled surgeons and
suggest robots can close that gap.
And as we know, people have been using telemedicine, Tele
robotics to perform surgeries for a while.
But if the fingers can be nimble enough in an optimist robot,
Elon Musk thinks that yes, Elon Musk's optimist robot could
perform heart surgery on people. But can a general purpose robot
earn enough trust in the operating room?
Tesla plans a new Optimist showcase in early of 2026, and
the company is building the manufacturing line it says will
scale toward 1,000,000 units a year.
Now, in this episode, I'll explain what Optimist can do
today, what Tesla says will change by the next model, and
what it would take for any robot to approach autonomous clinical
work. Also, breakdown the regulatory
wall that stands between a demo and a cleared medical device.
And we're gonna talk about what this plan signals to investors.
And we will get right into that after this very, very short
break. Now, Tesla positions Optimus as
a pathway from clean energy and cars into everyday robotics.
The company frames this as part of Master Plan Part 4, an
expansion from electrification to general technology that
tackles skilled tasks in the physical world.
That reset moves the discussion from quarterly vehicle numbers
to whether a new class of hardware and AI can take over
fine motor work. Now today's optimist can walk,
lift light items and handle fragile objects like eggs
without breaking them. Those are non trivial steps
because they require balance, object reorientation and grip
control that does not crush or drop that egg.
Tesla says the next iteration, expected for early 2026, will
include a handmade up of far more small components to enable
finer manipulation. That change, if it ships as
promised, would aim at the dexterity ceiling that separates
a warehouse picker from a surgical suture.
Now, Tesla says it is building manufacturing lines so the robot
can be produced at scale. The ambition here is up to
1,000,000 units per year once a full build is underway.
Mass production matters because volume spreads costs and pushes
suppliers to standardize parts around the design.
And volume also invites a software platform approach where
one hardware base runs different skills for homes, factories, and
eventually clinics. Now my analysis is that a large
installed base would let Tesla train and improve manipulation
skills faster, but it would not by itself grant clinical trust.
Elon Musk and Tesla have to earn that trust now.
Tesla's leadership connects optimist to healthcare by naming
surgery as a future target. The pitch is access.
Everybody could have a robot surgeon if a robot could perform
precise procedures reliably. Rural hospitals in undersupplied
regions could schedule care without waiting for scarce
specialists. The claim assumes safe autonomy
or near autonomy and high stakes settings.
Now my analysis is that even if Optimist progresses quickly, the
bar for surgical work is not a simple extension of warehouse
dexterity because surgical tasks couple fine motion with
millisecond level reactions to living tissue and changing
vitals. These are real people that the
Optimist robot is working on. This isn't a test.
These are people's lives on the line and this robot has to act
like a human, but better. It has to have the dexterity of
the top surgeons in the world, but better.
Now regulation sits at the center of that gap.
Though most medical robots in use today operate as tools
guided by human surgeon in the room and they went through
device specific testing and also those people have been trained
for decades. A robot that acts with broad
autonomy would face a higher standard stepwise validation and
multi year trials that match specific indications now.
Tesla would need to document safety at each stage, prove
failure handling for edge cases, and show repeatability across
patient autonomy, anatomy, and hospital environments.
Now, I think that even with strong engineering, the review
timeline alone stretches any aggressive schedule.
The thing can barely pick up an egg right now.
It doesn't break an egg. That's great, but can it handle
a tool like a scalpel? Can it pick up a scalpel and
manipulate it, roll it in its fingers and also use it to
precisely cut into a person's body?
Only then, And that's one small thing that it has to do.
It has to do so many more things to become a successful surgeon,
for it to become a successful healthcare provider.
Now, I'm not counting Tesla and this robot out.
Optimus is a work of art. It's an amazing piece of
engineering, but when Elon says, and we all know Elon Musk time,
right when he says something's going to happen in two years, we
know not to hold our breath because it's probably not going
to happen in two years. Just like Tesla's full self
driving. It really hasn't happened yet.
Full autonomous driving hasn't happened yet.
He's been promising this since the beginning of Tesla.
Also, something like the Super heavy, the Starship super heavy,
he has said that it should be on the moon by now and of course
that didn't happen and you know why?
There is a lot of different reasons.
One of those reasons is regulatory strangleholds which
happened at Star base when I was there.
When I was on the side of the road on Hwy. 4 and I was
reporting on the Starship, the FAA was put in place to hold up
Tesla. At that point.
There was a lot of stuff going on, environmental reviews.
They had to review that whole environment so SpaceX could
launch the Starship. And because of that, they were
behind about nine months. Now, with my time there, I know
that they do work aggressively, and if the Optimist robot team
are working just as aggressively as SpaceX was on the Starship, I
know they're working hard and I know that they want this thing
to succeed as fast as possible. Now, regulations, now that's
another thing. There's going to be a lot of red
tape. Even if Optimist can do certain
things, how do you get it into an environment and test it and
make sure that everything is OK with regulations and also with
the robot and also with the patient.
It's going to take years, maybe a decade from now before this
thing actually does real work on a person.
I'm not saying like stitch somebody or put a Band-Aid on
somebody. I'm saying like this thing can
you walk into an operating room and you see a team of optimist
robots. Each team has a specialty.
Each person on the team has a specialty and that robot itself
knows everything about that specialty and can do that job
better than a human. That's not going to happen
anytime soon. I, I hope it happens in the next
20 years because that would be an amazing feat.
And if these robots are as affordable as Elon says they're
going to be, he says 20 thousand, $30,000, something
around that. Then yes, the hospital in rural
America, the hospital where I grew up in the middle of
nowhere, in the middle of the forest could have an optimist
robot. And that optimist robot could
save hundreds of lives. It's a car crash, people
bleeding out the optimist robot. You could have a dozen optimist
robots ready to go at any time. Instead of having a specialist
come in from a city that's two hours away, instead of having a
specialist come in from someplace that's far away, then
specialist is already asleep. 2 hour drive.
But also you have to wake the specialist up.
You have to get them ready. That takes 15 or 20 minutes.
These people are dying in your operating room.
You could have a dozen Optimist robots ready to take over when
that accident happened and these people show up at the ER and
they are ready to be worked on. Now, if that's going to be the
case in the next 20 years, this is going to revolutionize
healthcare. This is going to save so many
people, and the population is going to go up as well.
So what is the overall outcome of this?
People will survive longer, more people will be alive for a
longer amount of time, and also the costs for surgery will go
down tremendously because surgeons will be getting cut out
of the whole process. Do you think that's going to
happen easily? Do you think surgeons are going
to be replaced by robots overnight?
I don't think so. Surgeons and also hospital
workers, you know what? They have Ways and Means to
fight this. They have unions.
And this is not going to happen without a huge fight from the
surgeons. Those people that paid 100,000
two, $100,000 to get that degree to be the best surgeon, the best
brain surgeon in their area. Of course they're not going to
go down without a fight. I mean, they're not going to,
the hospitals are not going to take these Optimus robots in for
high end surgeries for a long time anyway.
And by that time, the little things, the triage, you know,
getting people into the system and seeing them if they have a
cut or a scrape, something like that, or stitches, that's cool.
But if they need them for high end surgery, that's going to be.
And I don't, I hate to be this person that's always, I'm not
always like this. I'm never, I don't want things
to happen far down the line because I want to see them
happen. I want to see this robot and I
want to see other robots in this space do surgeries because I
think it's going to help so many people and I want to help a lot
of people. So I don't want to be the
naysayer here, but I know how technology works and I know what
it's like to get any sort of practical application for
healthcare from a robot. Even even Apple, when they made
the, the, the Apple Watch and they started putting health
gadgets on it, there was a lot of regulatory tape.
They have to go through all that and Optimist can't even like
sometimes they can barely walk. It dances around a little bit,
but we've all seen the Optimist robot stumble around.
You can't have that in a surgical environment.
You can't have that at a hospital.
Now, the next 6 models, 7 models, sure they'll be better.
And of course the robotics and the AI that is trained on it's
going to be so much better in the next 3-4 years.
And we have seen great growth by the optimist team and the robots
have been getting so much better.
But doing a doing surgery is going to be a a wild thing for
this thing. A Tesla says it is still early
and that work though and moving from general hand to a surgical
capable system would require sterile field design materials
that withstand cleaning protocols, biocompatibility,
sensor redundancy, fail safe controls that degrade gracefully
if a component slips outside its normal range.
So if the dexterity in the finger stops working when it's
to say they have somebody opened up and something happens in the
dexterity the the hand fails, what happens then?
Do they send in a real surgeon, a person surgeon to take over
and they have to have fail safe controls that it just doesn't
happen You know if a component slips outside its normal range
it needs to have a backup, needs to have redundancies.
Hospitals would need training pathways for staff too if this
happens. Procedures for pre op checks and
incident reporting automation would be a huge factor for these
types of robots. And 3rd, you know, those are
baseline requirements before a pilot even touches a patient,
before any sort of optimist robot touches a person.
Now, engineering for hands is the next step.
Tesla says the next hand will have more small parts to expand
Fine motor control. A surgical task such as tying a
knot, placing A suture at a specific depth or handling
delicate tissue requires fingertip for sensing, tactile
feedback loops and high frequency control that dampens
tremor while preserving speed. Cameras and depth sensors must
resolve soft tissue without losing tracking in fluids, body
fluids, and so a path exists for this, but only if software
sensing and actuation progress is in lockstep.
A stronger hand without robust perception will not deliver even
one safe stitch. Now Elon and Tesla planned for
one million robots a year. They are going to make the
supply chain for actuators, sensors, and the compute plus
test rigs that validate every joint before shipping these
things out. It's like making vehicles but
instead of making vehicles you make robots.
It's all an assembly line. It also implies field service
networks, replacement parts, logistics, and over the air
update discipline that treats a hand controller bug as a safety
issue and not just a delay. And also when do they do the
over the air updates? Is it when optimist is docked?
If there's a recall, when do they recall these?
And if there's a big enough recall in there are optimist
robots all over the country, all over the world performing
surgeries and the recall happens in the the recall is for surgery
robots immediately. What happens then if Tesla
reaches volume in non medical environments?
First, it could bank telemetry to tune manipulation models.
So what that means is that they ship out a million robots.
Every one of those robots, just like Tesla's vehicles right now,
test the environment. They test every part of that
robot until they get so much data that they'll be able to
make the medical robots. This data would be valuable but
would still need domain adaptation before they inform
clinical moves. You know, I've been digging
through the analysis of the show.
Speaking of analysis, and notice that 37% of you are following
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Now they have to be clinically ready as well.
They have to prove sub millimeter accuracy on bench
tests with standardized phantoms that mimic human tissue.
That has to be in the works for years.
Second, complete supervised procedures in simulation and
animal models where the robot handles part of a task while the
human controls the rest. Third, conduct early human
trials for tightly defined steps like holding and positioning
instruments while a surgeon, a human surgeon executes the
critical cut. Now each milestone needs
quantified failure modes, alarm thresholds, and intervention
handoffs. Medical robots must earn the
trust of real surgeons, little by little, every tiny step.
Now humans will be in this loop for every step.
They'll remain essential for years, maybe decades.
Even advanced robots will face edge cases such as unexpected
bleeding and allergic reaction or tissue differences that could
confound pre op. Imaging systems must escalate to
a human and accept immediate override without lag.
People should be able to take over at any moment.
Training will focus on teams, not just those machines.
So anesthesiologist, nurses and surgeons act from a shared
mental model and what the robot does, what it is sensing and
when it will pause, we'll all be monitored by people.
The most credible near term optimist use in a hospital would
be non invasive logistics, sterile handling, or room
turnover where error costs very very little and throughput still
improves care. Now, would you want an optimist
robot to operate on you or even dress your bandage to stitch you
up? Now, the promise of universal
access to top care is a huge thing, but people might not want
it in a patient education must match the reality of early
deployments for the trials. Stay transparent about what the
robot controls and what a human controls.
That's a good thing. Tesla must tell in all of its
marketing that humans are still in control for a very long time
and if there's any incident risks, this is going to set them
back tremendously. They need steady, transparent
reporting on task level outcomes because if they don't do that,
people will not trust this robot and they will not want it to
operate on them. You know, there will be some
early adopters and that's great. We need those people.
We did those people that really want a robot to be their surgeon
and not a trained professional who's been going through school
for 10 years. So I don't know the the Tesla
road map for 2026 will be an early proof point hopefully.
Do they do a great demo? A finer manipulation, and it
would show whether the new hand delivers controlled, repeatable
grasps that match tasks like threading, knot tying, or even
instrument passing. Now, if Tesla pairs that demo
with documentation, if they show off the robot, that's great.
But if they show how they did it, they would be even better
because people could see behind the scenes.
And if the demo stays at the level of stage tasks without
metrics, clinicians might not even look at this thing.
They'll keep treating surgical ambitions of this robot as an
open question. Now.
Specifically, this will be the difference maker next year, and
it's going to be the difference between hype, the Elon hype as
usual, or people actually thinking this robot is going to
be a viable healthcare professional in the future.
Hey, thank you so much for listening today.
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