I guess I misunderstood what an autopilot is for. When you're out on the open waters can't you just set it for a heading and it will steer the boat?
Yes, definitely misunderstood. AP has two general modes. Steer a course - say 90-degrees (due east). Problem with that although the boat is steering 90-degrees , wind and waves may push the boat off course forcing it to crab to 80 or 100 degrees true course.
The second mode is steer to waypoint, often as part of a longer route. In this mode the AP will compensate for current or wind and always aim towards the waypoint.
Steer to waypoint is obviously more reliable. So why not set and forget? Cross traffic is possible (not all vessels have VHF), you should have someone man the VHF as good practice, not unheard of for a chart plotter to freeze and just let the AP keep chugging along, effective in heading mode, on long legs the leg itself hasn't been zoomed in for obstructions, watch should look, listen, and smell for any unusual activities on the boat, and a few other reasons.
Bottom line. AP is an incredible useful tool. More or less fills the shoes of a crew on board. A couple can crew a boat with an AP. Without it, hand steering means three would be minimum. But it doesn't alleviate need for a watch
Peter