Current AI health tools share the same flaw as traditional healthcare: they're episodic, not continuous. OpenClaw — a nerdy new tool that’s shot to 2 million users in nothing flat — shows us what comes next: AI assistants that monitor your health 24/7, cross-reference data sources, and act on your behalf without being asked.

For the last 50 years, the engine of technology innovation has been a consumer engine. Consumers have steadily accumulated new health capabilities—including diagnosis, treatment, and monitoring—much faster than healthcare organizations. This has caused a decades-old, large-scale migration of health-related activity from the healthcare system to the consumer tech system. But in my experience speaking with hundreds of healthcare CEOs and board members, these migrations remain largely invisible to healthcare leadership.

The FDA just updated its General Wellness guidance, allowing consumer devices to measure clinical parameters for coaching—no clearance required. The same week, Utah let AI renew prescriptions with no doctor. Both are doing the same thing: moving healthcare tasks out of traditional systems and into consumer channels.

AI health coaches aren’t just for athletes anymore. They’re starting to handle the day-to-day interpretation, advice, and treatment adjustments that once required doctors. From glucose monitoring to hypertension management, technologies like Dexcom, Teladoc, and Omada are quietly taking over the work of routine clinical decision-making. This new generation of digital health coaches marks the next step in a long trend — technology shrinking healthcare by making us need it less.

The overwhelming majority of health-relevant data —movement, behavior, speech, sleep — is now generated outside the clinical setting. As a result, health innovation is increasingly shifting toward consumer devices and tech platforms that actually hold the data — not the EHR or the healthcare system.

Hospitals worry about retail clinics and other healthcare competitors. But real disruption may come from outside healthcare entirely: cars that don’t crash. As autonomous driving becomes safer and more widespread, the revenue ripple effects on emergency departments, orthopedics, and imaging will be profound—and sooner than most systems expect.

The public conversation about AI in healthcare swings between extremes—some predict it will replace doctors, others that it will usher in a golden age for medicine. So which is it? In my recent American Family Physician editorial, I explore how AI is less a disruptor of doctors than a powerful accelerator of consumer-driven health.

Innovations like GLP-1 drugs, self-driving cars and AI therapy chatbots are driving down illness, injury and the demand for traditional care. Rather than just improving delivery, these shifts reduce the need for doctors altogether. Snack food CEOs are planning for an Ozempic world. Why aren’t healthcare execs?

As AI and smartphones put more diagnostic power into consumers’ hands, healthcare faces disruption not just within the clinic—but beyond it. From OTC drugs to pneumonia-detecting apps, selfcare is rising fast. This isn’t the future. It’s already here—and it’s shrinking the doctor’s role.

Smartphone apps that can diagnose pneumonia? FDA-approved machines that can diagnose conditions without a doctor? Robot psychotherapy? It’s not coming, it’s here now.

Most doctors, nurses, PAs, techs, and others in healthcare aren’t familiar with the term “disruption” and are unaware of how technological trends have already begun disrupting their current business models. This post is the first of three that will provide a basic understanding of the term, and the phenomenon.