Is Autonomous Driving Healthcare’s Most Important Competitor?
While I’ve spoken extensively about how healthcare is not paying enough—if any—attention to the technological changes that threaten its business model, I haven’t talked much about improvements in auto safety, including Tesla Full Self-Driving (FSD) and similar efforts in “autonomy” (i.e. autonomous driving).
Let me correct that with this post.
In 2024, U.S. traffic deaths dropped nearly 4%, the sharpest single-year decline in half a decade. The National Highway Traffic Safety Administration (NHTSA) credits this trend in part to technologies like automatic emergency braking (AEB), which will be mandatory on all new light vehicles by 2029. NHTSA estimates that AEB could prevent 360 deaths and 24,000 injuries annually once fully deployed.
That’s before you even factor in what’s coming next: widespread autonomous driving. Tesla’s Autopilot — definitely not yet a fully autonomous driving system — already reports one crash for every 7.4 million miles: seven times safer than the U.S. fleet average. Waymo’s driverless fleet in Phoenix has now driven tens of millions of miles with zero at-fault fatalities. These systems are getting better, quickly. They don’t speed. They don’t text. And they don’t fall asleep at the wheel.
And even now, before full autonomy is widespread, the downstream effects of safer driving technologies are already being felt—just not yet on hospital dashboards.
For 2019–2020, an average of 3.8 million emergency department (ED) visits for motor vehicle crash injuries occurred annually — about 3% of ED visits. And car crashes are not low-cost visits. They trigger trauma activations, CT scans, orthopedic surgeries, ICU stays, and weeks or months of rehabilitation.
In 2022, motor vehicle accidents in the US resulted in over $470 billion in total costs, including medical costs and the cost of lost lives, according to the CDC.
Which is exactly why a slow decline in motor vehicle trauma should be setting off alarms in every hospital boardroom.
Trauma, orthopedics, imaging, rehab—many of healthcare’s most dependable, well-reimbursed services depend not just on illness, but on accidents. And no single type of accident has been more reliable, more predictable, and more lucrative than the car crash.
Autonomy changes that.
Not overnight. But incrementally, and often invisibly. There’s no press release saying “trauma cases will drop 15% this year.” There’s just a software update. And then another. And another. Every version pushes trauma volumes a little lower.
If you run a trauma center, your real competitor might not be the hospital across town—it might be the software quietly reducing your patient volume from the outside.
And it is a major threat. Trauma centers are high fixed-cost operations. They can’t scale down neatly when volume dips. You still need the surgeon on call, the CT scanner, the blood bank, the full staff. When volume becomes unpredictable, the economics start to break.
Healthcare tends to expect disruption to look like a healthcare competitor—CVS Health, Walmart, Amazon Clinic. But true disruption rarely comes from within the market. Blackberry didn’t fall to another mobile phone company, it fell to Apple — a company that had never made a phone. Taxi companies didn’t fall to another transport company. They fell to software layered onto private cars.
Healthcare’s trauma volumes may fall to something even simpler: safer roads. And any strategic plan built around growing orthopedics, expanding trauma capacity, or maximizing downstream imaging needs to be re-examined through the lens of this shift.
What if car crashes drop 20% in five years — from software updates?
If you’re a healthcare executive, or board member, you might not need need to change your mission. But you do need to change your assumptions. You can’t control the crash rate — but you can control how prepared your system is for the rapidly-approaching world in which crashes are rare.
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