02/12/2026    Bryce Karulak, DPM

Podiatry’s Future with AI as the New Market Force

Commonly, I hear that we should have a broader
license and that we should have pay parity with
MD/DOs; both of which I agree with whole heartily.
However, what everyone seems to be ignoring is the
future of medicine with respect to AI. AI has
already been shown to be superior in diagnosis and
treatment for any number of diseases that a
primary care typically treats or at least
initially is the treating physician. Elon Musk, in
Fortune Magazine last month, stated that by 2030,
there will be more Optimus Robots that are far
superior to human surgeons and that it is
pointless to go to Medical School. Considering
what this one man has done and accomplished in his
life, I tend to take what he says seriously.

So let’s play out the natural progression of what
happens to podiatry when this large over taking
market force starts squeezing human physician
access. When you can go to a pharmacy and see an
AI model that can perform vitals and take blood
(or with the help of a low paid technician) and
you then can walk over to pharmacist counter and
get your meds almost immediately from a kiosk,
what will you choose and busy professional/
parent/ guardian, a person working two jobs that
can have access to this AI model at all hours?
What will PCPs do then? They will start by doing
procedures. In Texas, I know of one FP physician
who went to a 6 weeks course for plastic surgery
and now is doing augmentation in office. This
will squeeze our clinic practice as PCP’s
initially start moving into procedural based
practices such as our own.

What about the surgical side? As I mentioned,
Elon Musk stated that there will be more Optimus
Robots Surgeons that are better than our most
accomplished surgeons. Do I personally believe
this will happen by 2030? Not entirely but in 10
years, I absolutely believe this will be a real
threat. Insurance companies stand to save millions
of dollars by cutting us out. First these Robots
will take the bread and butter procedures such as
what orthopedic and general surgeons have been
training the Mako and DaVinci Robots for years
now. These companies have the data; Musk has the
robots.

Naturally, Ortho will start by working on more
nuanced parts of the body with highly variable
anatomy such as the foot and hand to help their
bottom line. Unfortunately, I don’t see
podiatry’s future in this new world. If we don’t
somehow assimilate with MD/DOs we won’t have a
future at all. I will always hope for the best
but will plan for the worst. What’s the APMA’s
plan or any podiatry related organization? To
think AI won’t affect us is foolish at best.

Bryce Karulak, DPM, San Antonio, TX

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02/13/2026    David Laurino, DPM

Podiatry’s Future with AI as the New Market Force (Bryce Karulak, DPM)

The largest merger in history just happened.
And it has everything to do with how you'll run
your medical practice in 2026. Two days ago,
SpaceX acquired xAI for $1.25 trillion. Most
people see a valuation story. I see a playbook:

? Vertical integration (own the infrastructure,
don't rent it)
? Cost collapse (do it cheaper than everyone else)
? Market dominance (move faster than regulators
can respond)

Here's what just combined:
• SpaceX (90% of global payload to orbit)
• xAI (200K+ GPUs, largest AI cluster on Earth)
• Starlink (9M subscribers, global satellite
coverage)
• X (billions of data points training Grok AI)

Now connect the dots for healthcare:
When Starlink's direct-to-cell V3 satellites
deploy, Grok will be accessible on every
smartphone globally...no app required.
When Tesla's Optimus robots scale, they'll handle
front desk, vitals, supply chain, post-op care, at
a fraction of human labor costs.

When Neuralink advances, real-time patient
monitoring becomes standard. The question isn't IF
this disrupts healthcare delivery. It's whether
YOUR practice will adapt before your competitors
do. I'm watching five indicators:

1. Practices experimenting with AI scribes and
automation
2. Ownership of patient data (not hospital
systems)
3. Multi-channel patient acquisition (not Google
ad dependence)
4. Vertical integration of scheduling, telehealth,
payments
5. Early adoption of robotics in non-clinical +
clinical tasks

The practices that survive the next five years
won't be the ones with the best doctors. They'll
be the ones that mastered AI and automation FIRST.

What's your move?

David Laurino, DPM, Gilbert+Chandler, AZ

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02/13/2026    David Laurino, DPM

Podiatry’s Future with AI as the New Market Force (Bryce Karulak, DPM)

The largest merger in history just happened.
And it has everything to do with how you'll run
your medical practice in 2026. Two days ago,
SpaceX acquired xAI for $1.25 trillion. Most
people see a valuation story. I see a playbook:

? Vertical integration (own the infrastructure,
don't rent it)
? Cost collapse (do it cheaper than everyone else)
? Market dominance (move faster than regulators
can respond)

Here's what just combined:
• SpaceX (90% of global payload to orbit)
• xAI (200K+ GPUs, largest AI cluster on Earth)
• Starlink (9M subscribers, global satellite
coverage)
• X (billions of data points training Grok AI)

Now connect the dots for healthcare:
When Starlink's direct-to-cell V3 satellites
deploy, Grok will be accessible on every
smartphone globally...no app required.
When Tesla's Optimus robots scale, they'll handle
front desk, vitals, supply chain, post-op care, at
a fraction of human labor costs.

When Neuralink advances, real-time patient
monitoring becomes standard. The question isn't IF
this disrupts healthcare delivery. It's whether
YOUR practice will adapt before your competitors
do. I'm watching five indicators:

1. Practices experimenting with AI scribes and
automation
2. Ownership of patient data (not hospital
systems)
3. Multi-channel patient acquisition (not Google
ad dependence)
4. Vertical integration of scheduling, telehealth,
payments
5. Early adoption of robotics in non-clinical +
clinical tasks

The practices that survive the next five years
won't be the ones with the best doctors. They'll
be the ones that mastered AI and automation FIRST.

What's your move?

David Laurino, DPM, Gilbert+Chandler, AZ