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 this channel, which I love you, thank you and for you I am
forever grateful. And the other 63% haven't hit the follower subscribe button yet. And I've been an independent journalist covering Elon Musk Space Flight in tech for the last six years. And I'm going to continue for the next 10 years. All I ask for you is one second of your time and you just hit the follow or subscribe button on the platform you're on, which you're watching or listening on right now. I'm extremely grateful for you and I'm blessed to have you in
this community. So thank you for doing that. 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. I really do appreciate your support.
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