I see it like this.
Austin guesses that Sarah is alive. He arranges for his car to crash by weighing down the accelerator with a huge rock and shoving it off the road.He has also drenched the interior with gasoline so the car will burn. Lucy was not in the car; Austin had left her behind at the rehearsal. The police assume Austin is in the car but they can't tell while it is burning. That's when the doctor offers to identify the body so Sarah can go home. The last scene with the doctor shows him and the police standing near the car, waiting for firefighters to extinguish the blaze. At some point, they realize no one is in the car and the doctor knows it was all a set up. He races to Sarah's house but arrives too late.
Meanwhile, Sarah returns to the house, takes a shower, and hears the front door open and close. She thinks it is the doctor. What she doesn't realize is that Austin has been in the house all along, waiting for her. He opens and closes the door so she will think someone has just come in. To save time, he is already undressed and quickly slips into the bed. She goes toward him, thinking he is the doctor. He grabs her, pulls her down roughly, and at that point she recognizes him. Screams galore. After killing her, Austin quickly gets dressed and slips out of the house. Lucy is waiting for him and they drive off into the sunset, in her car. This is when the doctor bursts into the bedroom and finds Sarah dead.
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