Report finds Houston is short on health care workers

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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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How this Houston innovator's tech is gearing up to impact EV charging, energy transition

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With more and more electric vehicles on the road, existing electrical grid infrastructure needs to be able to keep up. Houston-based Revterra has the technology to help.

"One of the challenges with electric vehicle adoption is we're going to need a lot of charging stations to quickly charge electric cars," Ben Jawdat, CEO and founder of Revterra, says on the Houston Innovators Podcast. "People are familiar with filling their gas tank in a few minutes, so an experience similar to that is what people are looking for."

To charge an EV in ten minutes is about 350 kilowatts of power, and, as Jawdat explains, if several of these charges are happening at the same time, it puts a tremendous strain on the electric grid. Building the infrastructure needed to support this type of charging would be a huge project, but Jawdat says he thought of a more turnkey solution.

Revterra created a kinetic energy storage system that enables rapid EV charging. The technology pulls from the grid, but at a slower, more manageable pace. Revterra's battery acts as an intermediary to store that energy until the consumer is ready to charge.

"It's an energy accumulator and a high-power energy discharger," Jawdat says, explaining that compared to an electrical chemical battery, which could be used to store energy for EVs, kinetic energy can be used more frequently and for faster charging.

Jawdat, who is a trained physicist with a PhD from the University of Houston and worked as a researcher at Rice University, says some of his challenges were receiving early funding and identifying customers willing to deploy his technology.

Last year, Revterra raised $6 million in a series A funding round. Norway’s Equinor Ventures led the round, with participation from Houston-based SCF Ventures. Previously, Revterra raised nearly $500,000 through a combination of angel investments and a National Science Foundation grant.

The funding has gone toward growing Revterra's team, including onboarding three new engineers with some jobs still open, Jawdat says. Additionally, Revterra is building out its new lab space and launching new pilot programs.

Ultimately, Revterra, an inaugural member of Greentown Houston, hopes to be a major player within the energy transition.

"We really want to be an enabling technology in the renewable energy transition," Jawdat says. "One part of that is facilitating the development of large-scale, high-power, fast-charging networks. But, beyond that, we see this technology as a potential solution in other areas related to the clean energy transition."

He shares more about what's next for Revterra on the podcast. Listen to the interview below — or wherever you stream your podcasts — and subscribe for weekly episodes.


Report: Houston's hot medical office market might be on track to cool

by the numbers

Houston’s medical office market is on a roll.

A report from commercial real estate services company JLL shows net absorption and transaction volume saw healthy gains in 2022:

  • The annual absorption total of 289,215 square feet was 50.5 percent higher than the five-year average.
  • Transaction volume notched a 31.7 percent year-over-year increase.

Meanwhile, net rents held steady at $26.92 per square foot, up 1.3 percent from the previous year. The fourth-quarter 2022 vacancy rate stood at 15.9 percent.

Despite those numbers, the report suggests a slowdown in medical office rentals may be underway.

“Tenants who may have previously considered building out or expanding their lease agreements are now in a holding pattern due to increased construction costs and higher interest rates,” the report says. “These factors are having a direct impact on financial decisions when it comes to lease renewals, making it more likely that tenants will remain in their existing location for the foreseeable future.”

Still, the report notes “a number of bright spots for the future of healthcare in Houston.” Aside from last year’s record-high jump in sales volume, the report indicates an aging population coupled with a growing preference for community-based treatment “will lift demand even higher in coming years.”

The report shows that in last year’s fourth quarter, 527,083 square of medical office space was under construction in the Houston area, including:

  • 152,871 square feet in the Clear Lake area.
  • 104,665 square feet in the South submarket.
  • 103,647 square feet in Sugar Land.
Last fall, JLL recognized Houston as a top city for life sciences. According to that report, the Bayou City lands at No. 13 in JLL’s 2022 ranking of the country’s top 15 metro areas for life sciences. JLL says Houston “is poised for further growth” in life sciences.

Houston financial services firm announces acquisition, plans to grow

M&A radar

A Houston-based financial services company has made a recent strategic acquisition that gives it a new banking status.

LevelField Financial, which is creating a platform that combines traditional banking and digital asset products and services, announced this week that it is acquiring Burling Bank, an FDIC-insured, Illinois state-chartered bank. According to the company, once it receives regulatory approval, "LevelField will be the first full-service bank to offer fully compliant traditional banking and digital asset services."

The financial terms of the deal's transaction, which is expected to close later this year, were not disclosed.

The combined company will be able to provide traditional banking services, as well as LevelField's digital asset management. Burling Bank's senior management team will join LevelField's leadership, per a press release. They will focus on serving the bank's existing clients and growing the banking business nationwide.

"We conducted a broad review of banks in the U.S. to find the ideal institution with both an existing business and a management team who are aligned with our vision; we exceeded our expectations with Burling Bank. With this acquisition, LevelField will become a traditional bank, albeit one serving customers interested in the digital asset class," says Gene A. Grant II, CEO of LevelField Financial, in the release.

"We are thrilled to have the Burling executives join our leadership team, and together we intend to deliver fantastic customer service and well-designed products to customers who have an interest in accessing the digital asset class through a traditional bank," he continues.

Founded in 2018 by former banking executives, LevelField's leadership believes "the future of money is digital and that banks will continue to be a trusted provider of financial services," according to the website. This acquisition comes ahead of the company's plans to expand nationally.

"LevelField's strategic approach presented a tremendous opportunity for the bank to expand beyond our local footprint and serve customers with shared interests across the nation," says Michael J. Busch, Burling Bank president and CEO. "Together, we will continue to provide superior service and demonstrate that we truly understand the expanding and unique needs of our customers. Additionally, through the carefully developed suite of products we can address our customers' interests in digital assets and introduce them to LevelField's safe, simple, and secure platform."

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