A report found that Houston has only 3.35 health care workers for every 100 residents. Getty Images

Houston may be home to the world's largest medical center, but a new study indicates the region is also home to one of the lowest rates of health care workers among major U.S. metro areas.

The study, released by credit-building loan platform Self, shows the Houston metro area has 3.35 health care workers for every 100 residents. That places Houston at No. 10 on the study's list of the major metro areas (at least 1 million residents) with the lowest share of health care workers per capita, including doctors, nurses, and therapists.

The only other major metro area in Texas sitting toward the bottom rung of the ladder is Austin, with 3.17 health care workers per 100 residents. That puts Austin at No. 4 for the lowest rate of health care workers among major metro areas.

Houston's ranking in the Self study is juxtaposed with the city's status as a world-famous health care hub. Over 106,000 people work at the more than 60 institutions within the Texas Medical Center, which includes the University of Texas MD Anderson Cancer Center, Texas Children's Hospital, and the Baylor College of Medicine.

The 1,345-acre medical complex pumps an estimated $25 billion a year into the regional economy.

Despite Houston's stature as a medical magnet, the metro area is witnessing an escalating shortage of doctors and nurses.

A 2016 report from the Texas Department of State Health Services envisions the supply of registered nurses (RNs) — the largest group of nursing professionals — will climb 38 percent from 2015 to 2030 in the Gulf Coast public health region, compared with a 60.5 percent surge in demand. That equates to a projected shortage of 13,877 RNs in 2030. The Gulf Coast region includes the Houston area.

From 2017 to 2030, the supply of primary care physicians in the Gulf Coast region will increase 19.8 percent while demand will spike 27.5 percent, according to a 2018 report from the Texas Department of State Health Services. Ten years from now, the region will suffer a shortage of 694 primary care physicians, the report predicts.

In a 2019 survey commissioned by the Texas Medical Center Health Policy Institute, about 90 percent of primary care physicians across the country predicted a shortage in their field within five years. Seventy-eight of specialty physicians anticipated a shortage of specialists.

On the consumer side, the survey found 19 percent of patients reported difficulty scheduling an initial visit with a primary care physician, and 15 percent ran into trouble setting up a new visit with a specialist.

"The best way to tell if we have a doctor shortage is by asking patients whether they can easily get an appointment," Dr. Arthur "Tim" Garson Jr., director of the Texas Medical Center Health Policy Institute in Houston, said in a 2019 release. "For now, they overwhelmingly say 'yes.'"

By 2030, Texas will experience the third largest shortage of physicians among the states (20,420 jobs), according to a study published in 2020 in the journal Human Resources for Health. Only California and Florida will see worse shortages, the study predicts. The physician shortage in Texas is being driven by a growing population, an aging population and an aging pool of doctors, according to the study.

Noting the country's growing and aging population, a study published in 2019 by the Association of American Medical Colleges predicts the U.S. confronts a shortage of up to 121,900 physicians by 2032.

The looming national shortage of RNs is also acute.

The country's RN workforce is projected to grow from 2.9 million in 2016 to 3.4 million in 2026, or 15 percent, according to the U.S. Bureau of Labor Statistics. However, the bureau predicts the need for another 203,700 RNs each year from 2016 through 2026 to fill newly created positions and to replace retiring nurses.

"With patient care growing more complex, ensuring a sufficient RN workforce is not merely a matter of how many nurses are needed, but rather an issue of preparing an adequate number of nurses with the right level of education to meet health care demands," Ann Cary, dean of the Marieb College of Health and Human Services at Florida Gulf Coast University, said in a 2019 release

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Efficient referrals from doctor to doctor could save a life, so this Houston company is setting out to create a network of medical professionals all accessible in an app. Getty Images

Houston-based company is connecting the dots on patient referrals

Diagnosing doctors

When your doctor recommends that you visit another practitioner, it's only natural that you trust the suggestion. But it's one case in which your physician isn't always an expert. Married doctors Justin Bird, an orthopedic surgeon, and Terri-Ann Samuels, a specialist in female pelvic medicine and reconstructive surgery, have long noted that patients are often referred incorrectly.

No big deal, right? Just go to another doctor. But not everyone has that luxury. Bird and Samuels never intended to start their own company. But when Bird lost a patient due to faulty referrals, they knew something had to be done.

"He believes that if she hadn't been bounced around from doctor to doctor, they could have saved her life," says Chris E. Staffel, chief operating officer of Patients We Share, the app that the couple created to fix the broken aspect of the health care system.

In 2015, Bird and Samuels began their company when they were shocked to realize that such an app didn't already exist.

"They started working with physicians around the country who said, 'We really, really need this,' and they also invested in it," recounts Staffel. From those friends, they built a physician advisory board of 15 investors.

Prescribing growth
The project was accepted into Johnson & Johnson's incubator, JLABS in 2016, then TMCx's digital startup program in the spring of 2018.

"They started realizing it was gaining momentum and realized they needed to have business people on board," says Staffel.

They hired Michael Antonoff, a Rice University M.B.A., as CEO. He invited former classmate Staffel to join as COO. Having come from a background in oil and gas, Staffel jumped at the chance to try her hand in a different industry.

With new business clout behind PWS, the company is growing quickly. Currently, PWS is entering its next seed round of $2.5 million that will allow the company to pay salaries of new team members and bring some tech development in-house. Until now, the making of the app itself has been outsourced to Mobisoft Infotech, a company based in Houston and India, which has worked on many projects at the Texas Medical Center. Local Black + Grey Studio is responsible for the design.

PWS has been working with both those teams in recent months to get a prototype app ready for launch. Currently, 100 physicians around the country are part of an invite-only pilot program. Soon, Staffel hopes to allow early adopter doctors who haven't been invited to enroll in the program for free. It will likely be in 2020 that patients will start joining the community, too.

How it works
An index of all the providers on the app allows doctors to easily find practitioners in a particular specialty. But there's more to it. Detailed profiles contribute to machine learning that assures the optimal match every time. Patient reviews will also play a role.

Though referrals were the impetus for the creation of PWS, it may be even more important as a communication tool between doctors, fellow clinicians (anyone from nurse practitioners to physical therapists may be invited to join), and patients. Staffel says participants in the pilot program are already using the messaging system to compare notes on cases, even sending photos from surgery to consult on patient issues.

The app's encryption means that it's HIPAA-compliant. Patients provide permission to discuss their cases via the app. And they can be confident of the quality of care they'll receive. Likely, the app will remain largely invite-only, and everyone who joins will share their National Provider Identifier licenses to be vetted against the federal database.

Doctors will communicate directly with patients through the app, but will also share resources digitally. Instead of making copy after copy of information about post-surgical care, for instance, the physician need only press a button to share a link.

Eventually, the goal is for PWS to be used not just nationally, but internationally, not just by individuals, but by whole hospital systems. A world in which doctors can compare notes around globe could be a little safer for us all.

Houston-based Memorial Hermann could soon be part of one of the largest health care networks in Texas. Photo via memorialhermann.org

2 major Texas hospital systems merge with service and innovation in mind

2 for 1

Two powerhouse medical centers have decided to team up to become one of the largest health care systems in Texas.

Houston-based Memorial Hermann Health System and Dallas-based Baylor Scott & White Health's board members signed a letter of intent to merge and create a combined system, according to an October 1 press release. A definitive agreement is expected to be complete in 2019.

"Together, we believe we will be able to accelerate our commitments to make care more consumer centric; grow our capabilities to manage the health of populations; and bend the unsustainable healthcare cost curve in the state," says Chuck Stokes, president and CEO of Memorial Hermann, in the release. "Through this combined system, we have a unique opportunity to reinvent healthcare and make a profound difference in the lives of millions of Texans."

The two systems together have over 68 hospital campuses, 1,100 care delivery sites, almost 14,000 physicians, and serve almost 10 million patients each year, according to the release.

The combined organization will operate under a unified board, led by Ross McKnight, the current chair of the Baylor Scott & White Holdings Board of Trustees. A vice chair will be selected by Memorial Hermann and will serve as the chair after McKnight's two-year term.

Jim Hinton, current CEO of Baylor Scott & White, will be the CEO. Stokes will serve in the proposed office of the CEO, along with current Baylor Scott & White president, Pete McCanna.

"Baylor Scott & White was founded as a Christian ministry more than 100 years ago; ever since, it has advanced health and driven change in North and Central Texas," McKnight says in the release. "This proposed combination starts the next chapter in the legacies of service and innovation for both systems. It will not only make a positive difference in the lives of millions here, it will become a national model."

Both organizations will maintain their brands and names locally. Executive and support staff will be based in the cities where the two entities currently have operations: Austin, Dallas, Houston, and Temple.

"This is about two mission-driven organizations — both committed to making safe, high-quality healthcare more convenient and affordable — building something transformative together," Hinton says in the release. "We must lead the change in our industry, while insisting we continue to fulfill our unwavering commitments to meeting the needs of all Texans."

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Intuitive Machines lands $600M satellite deal, NASA ‘spacecraft bus’ contract

space deals

Houston-based space infrastructure company Intuitive Machines has scored two astronomical deals.

The deals add to the company’s soaring success. As of June 30, Intuitive Machines had a record-high $1.8 billion backlog of orders, a $1.5 billion increase from the end of last year. The current backlog includes orders for more than 80 spacecraft.

The company, which went public in 2023, expects this year’s revenue to total $900 million to $1 billion. In the first half of 2026, Intuitive Machines generated nearly $393 million in revenue.

Intuitive Machines estimates its total available market is valued at more than $150 billion.

$600 million-plus deal represents ‘important milestone’

On Monday, Intuitive Machines said it picked up a $600 million-plus deal to develop three commercial satellites for an undisclosed customer over the course of about two years.

Intuitive Machines says it will design, manufacture, set up and support several spacecraft “for a critical communications infrastructure mission.”

Steve Altemus, the company’s CEO, says the deal represents “an important milestone for Intuitive Machines and reflects the confidence our customers place in our ability to deliver high-performance spacecraft for a broad range of mission needs.”

Company nails down NASA deal for ‘spacecraft bus’

A day after announcing the $600 million-plus deal, Intuitive Machines said it secured a new contract with NASA.

Intuitive Machines says NASA’s Jet Propulsion Laboratory in Southern California will use the company’s IM 300 “spacecraft bus” for an EAGLE-VSWIR Earth observation mission. The mission is scheduled to launch in 2028.

Aside from supplying the IM 300 bus, Intuitive Machines will carry out mission support services.

The low-Earth-orbit mission will be equipped with Intuitive Machines’ hyperspectral visible to shortwave infrared (VSWIR) instrument. This technology sees colors and details that aren’t visible to the human eye.

The instrument is “designed to perform surface biology and geology observations from Earth orbit while demonstrating technologies that could support future lunar and Mars exploration missions,” Intuitive Machines says.

Intuitive Machines builds mission-critical spacecraft, systems, and infrastructure for business and government customers. To date, the company has produced more than 300 spacecraft, delivered over 575 pounds of payload to the moon and launched about 100 satellites.

9 Houston-based companies make Fortune Global 500 list in 2026

Worldwide Rankings

Nine Houston companies landed on the 2026 Fortune Global 500 list, which ranks the world's largest corporations by revenue for the 2025 fiscal year.

Houston's showing on the list was led by energy companies, with Spring’s ExxonMobil claiming the top local spot. Here’s what Houston-area companies made the list, and where they ranked:

  • No. 15 ExxonMobil
  • No. 36 Chevron
  • No. 61 Phillip 66
  • No. 159 Sysco
  • No. 243 ConocoPhillips
  • No. 292 Enterprise Products Partners
  • No. 343 Plains GP Holdings
  • No. 460 SLB
  • No. 481 Hewlett Packard Enterprise

After 12 years as No.1, Arkansas-based Walmart was replaced this year by Seattle-based Amazon in the top spot for 2026. Amazon achieved this by bringing in $700 billion in revenue in 2025, representing a 12 percent increase from the previous year.

"Across global business, we see again and again that the leaders who are winning are those who embrace change,” Alyson Shontell, Fortune's editor in chief and chief content officer, said in a news release. "Amazon has topped the Fortune Global 500, knocking Walmart off its pedestal. The company has continually reinvented itself across new businesses and bold bets—including a $200 billion capital commitment, largely to building its capacity for AI and cloud computing, in this year alone."

The U.S. has 141 companies on the 2026 Fortune Global 500 list, which is the most of any country. Companies in America generated $15.5 trillion in aggregate revenues, a 6 percent increase from the previous year.

The number of women CEOs at Fortune Global 500 companies reached a record of 34 top leaders, who represented 6.8 percent of CEOs of companies on the list.

Technology was the standout growth industry on this year’s list, with 38 companies earning revenues that grew 20 percent to about $4 trillion in 2025, with profits climbing 36 percent to $835 billion. The financial sector accounted for the largest share of companies on the list again, with 123 companies in that sector. The energy sector claimed the No. 2 industry spot with 77 companies making the list.

In June, the Fortune 500 list was released, and Texas led the United States with 57 Fortune 500 companies headquartered in the state, generating $2.8 trillion in combined revenue.

Fast-growing Houston real estate startup surges to No. 7 on Inc. 5000

growth report

Houston-based Epique Realty has ridden the AI wave to rank among the Inc. 5000’s 10 fastest-growing private companies.

With three-year revenue growth of 23,210 percent, the AI-powered real estate brokerage appears at No. 7 on this year’s Inc. 5000 list. The 2026 list ranks private companies based on percentage revenue growth from 2022 to 2025.

Epique, founded in 2021, also ranks as the No. 1 fastest-growing company in Houston, No. 1 fastest-growing real estate company in the U.S., and No. 2 fastest-growing company in Texas.

Epique’s annual revenue surpasses $91 million

Between 2022 and 2025, the company’s annual revenue skyrocketed from $391,654 to more than $91.2 million. In 2025, the brokerage closed more than 23,000 deals and surpassed $7 billion in total sales, elevating Epique to the country’s 14th-largest real estate brokerage as measured by volume.

Epique’s network has more than 4,000 agents.

“To debut in the top 10 of the Inc. 5000 is absolute proof that when you relentlessly put agents first, exponential growth takes care of itself,” co-founder and CEO Joshua Miller said in a news release.

“We didn’t achieve this by following the industry playbook; we achieved this by burning it,” Miller added. “By fully funding our agents’ success through free health care, proprietary AI, and world-class leads, we’ve built a company where agents can finally thrive.”

The company’s other co-founders are Chris Miller, chief operating officer and vice president of expansion, and Janice Delci, chief financial officer.

Epique expands business to Canada, Mexico, Australia

The Millers and Delci have guided the company’s rapid expansion.

“Scaling our corporate support team to match [our] hyper-growth while seamlessly expanding across all 50 states and internationally to Canada, Australia, and Mexico takes an incomparable operational infrastructure,” Miller said.

“We have built an enterprise-grade technology ecosystem that allows us to absorb overhead and empower our agents at lightning speed,” he added. “This ranking validates that our disruptive model is working, and it is completely redefining the global industry standard.”

Epique launched its platform in 2023, touting itself as the industry’s first AI-powered brokerage. The startup’s platform provides AI tools for real estate agents to improve their marketing, streamline content creation, and boost engagement with clients and prospects.

Among Epique’s AI tools are:

  • ChatGPT for generation of property descriptions
  • AI-assisted creation of blog posts and agents’ bios
  • Production of Instagram quotes for social media marketing

“When we started Epique, we wanted to build a company that genuinely cared for its agents’ financial and physical well-being,” Delci says. “To see that vision translate into this level of historic record-breaking growth is a beautiful testament to the true power of radical generosity.”

Epique and fellow honorees will be recognized Oct. 14-16 at the 2026 Inc. 5000 Conference & Gala in Dallas.

Six other Houston-area companies land in top 250

Here are the six other Houston-area companies that claimed spots in the top 250 on the Inc. 5000 list. Each company name is followed by its ranking, headquarters city, and three-year growth rate.

  • No. 27 Empact Technologies, 8,275 percent
  • No. 60 Action1, 4,512 percent
  • No 75 Signs By G, 3,684 percent
  • No. 79 The ’Pause Life, 3,469 percent (Galveston)
  • No. 110 Turtlebox Audio, 2,576 percent
  • No. 178 Dahnani Private Equity Group, 1,904 percent (Stafford)

How did companies in Texas’ other major metros fare?

Here’s a breakdown of companies in the Austin, Dallas-Fort Worth, and San Antonio areas that made the top 250 on the Inc. 5000. Again, each company name is followed by its ranking, headquarters city, and three-year growth rate.

Austin (10 companies)

  • No. 9 Investment Watches, 15,741 percent
  • No. 72 Razor Metrics, 3,856 percent
  • No. 91 Autonomize AI, 2,921 percent
  • No. 102 Choose Your Horizon, 2,719 percent
  • No. 132 Wander Staffing, 2,296 percent
  • No. 144 Everyday Dose, 2,179 percent
  • No. 148 NetRise, 2,118 percent
  • No. 163 Nutrabound Labs, 1,999 percent (Bastrop)
  • No. 179 Steadily, 1,890 percent
  • No. 208 Tiny Health, 1,624 percent

Dallas-Fort Worth (11 companies)

  • No. 3 Yantran, 258,740 percent (Allen)
  • No. 12 Paek Management Group, 12,520 percent (Irving)
  • No. 82 Elite Robotics and Automation, 3,334 percent (Fort Worth)
  • No. 133 Outamation, 2,291 percent (Southlake)
  • No. 147 Red Creek Solutions, 2,119 percent (Frisco)
  • No. 155 JobTread Software, 2,071 percent (Dallas)
  • No. 164 DAX Eyewear, 1,977 percent (Nevada)
  • No. 186 Optimized Waste Removal, 1,830 percent (Fort Worth)
  • No. 204 Freight Flex, 1,642 percent (Denton)
  • No. 212 Maverick Power, 1,591 percent (McKinney)
  • No. 229 Innovative Life Sciences, 1,494 percent (McKinney)

San Antonio (one company)

  • No. 118 Hire With Near, 2,421 percent