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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Houston space companies take off with new tech, deals and contracts

space update

Space City has had a busy month.

Houston-based aerospace institutions Venus Aerospace, Axiom Space, and Aegis Aerospace have each recently announced advancements in their respective fields that include expansions and new contracts from U.S. and international government agencies.

Here’s the latest:

Venus launches new test stand

Earlier this month, Venus Aerospace added infrastructure to support the ongoing progress of its Rotating Detonation Rocket Engine (RDRE) with the opening of its new propulsion test stand at the Houston Spaceport.

The Texas Space Commission's Space Exploration and Aeronautics Research Fund is funding the test stand, which is part of a larger effort from the state to increase investments in the aerospace economy. The ribbon-cutting event on Sept. 10 welcomed officials from Venus Aerospace, the Texas Space Commission, the Houston Spaceport, Houston business and local community leaders.

With the new stand, Venus will be able to test at higher thrust and for longer durations, which will allow the company to better replicate real-life conditions.

"Building and testing propulsion systems at this pace requires the right infrastructure around the technology," Sassie Duggleby, CEO and co-founder of Venus Aerospace, said in a news release. "We're grateful to the Texas Space Commission and the State of Texas for investing alongside companies like Venus. Public investment like this helps companies move faster and keeps critical aerospace capability growing here in Texas."

Venus closed a $91 million Series B in July and expanded its leadership team.

Axiom partners in Europe

Axiom Space has signed a memorandum of understanding with the European Space Agency for “sustained European access to low-Earth orbit (LEO)” following the retirement of the International Space Station, according to a news release from the company.

Under the agreement, Axiom and the ESA agreed to explore future astronaut missions on the ISS and Axiom Station, research, transportation and spacesuit partnerships. The organizations will explore using the ESA’s European Cargo Return service and potentially a future European crew vehicle to support operations at Axiom Station, the company's forthcoming commercial space station. The partnership could also involve Axiom's AxEMU spacesuit for orbital and lunar applications, according to the release.

“With the upcoming de-orbitation of the ISS, it is our duty to anticipate and prepare future solutions to ensure our access to low-Earth orbit,” Daniel Neuenschwander, director of human and robotic exploration at ESA, said in the release. “The two documents signed today underline both our commitment to safeguard our ability to pursue in-orbit science and to keep offering flight opportunities to our European astronaut corps, as well as the growing interest of international partners for our ongoing project to develop an autonomous European cargo vehicle.”

The announcement comes as Axiom has made several international moves this year. The company shared plans to establish Axiom Space Switzerland this summer and launched Axiom Space Japan in July.

"The path to a sustainable human presence in space runs through international collaboration — reliable supply chains, shared innovation, and partners who bring real capability," Jonathan Cirtain, CEO and President of Axiom Space, said in the release. "Europe's contributions to microgravity science and deep space technology make ESA exactly that kind of partner. This MoU strengthens our work together, and we look forward to ESA and its member states joining us as customers for future astronaut missions."

Aegis expands DoW deal

Webster, Texas-based Aegis Aerospace announced that it has won a new task order to continue supporting the U.S. Space Force’s Space Test Program.

The contract starts in October and covers designing, building, testing and operating Department of War payloads or equipment on NASA, government, and commercial launch vehicles and platforms. The contract was issued by the USSF Space Systems Command, Space Test Program under NASA Johnson Space Center’s Research, Engineering, and Mission Integration Services 2 (REMIS 2).

Currently, the company is working on three payload facilities on the ISS and has plans for two more in development.

“Aegis Aerospace is grateful to continue our exceptional payload integration support to the USSF and the STP to meet their critical mission objectives,” President Matt Ondler added in the release. “This work is more important than ever to maintain U.S. superiority in space. This new contract will take us beyond the current life of the ISS and see us integrate and test payloads on commercial space stations, free-flyers, and cislunar missions.”

10 Houston billionaires land on Forbes' 2026 list of richest Americans

America's Richest

The richest billionaires in America have a collective worth of $8 trillion in 2026, a staggering $1.4 trillion increase since last year, says Forbes. American billionaires are so wealthy that it now takes an unprecedented $4.4 billion net worth to be considered one of the richest people in the country. And one local billionaire has regained the title as Houston's wealthiest resident.

Oil tycoon Jeffery Hildebrand, 67, now reigns as the No. 1 richest Houstonian, the 9th richest Texan, and the 88th richest person in America for 2026.

The annual Forbes 400 list is a definitive ranking of the wealthiest Americans, using interviews, financial data, and documentation provided by billionaires and their companies. In all, 43 billionaires across Texas made it on the 2026 list, and 10 are based in Houston.

Hildebrand's net worth has surged $4.7 billion since last year, bringing his current net worth to $14.7 billion. He cofounded Hilcorp, one of the largest privately owned oil and natural gas producers in the U.S., in 1990 and served as its CEO until 2018. He still serves as the chairman of the company.

Hildebrand skyrocketed past several other Houston billionaires to claim the top spot citywide: Kinder Morgan chairman Richard Kinder, Toyota mega-dealer Dan Friedkin, and hospitality honcho Tilman Fertitta.

Kinder, 81, was dubbed Houston's richest billionaire in the 2025 Forbes 400 list, whose net worth has increased from $11.1 billion to $12.9 billion in just one year. He is the 11th richest Texan and the 100th richest person in America.

Friedkin, 61, is the third-richest Houstonian and the 102nd richest American with an estimated net worth of $12.9 billion, up from $9.7 billion last year. He most notably owns Gulf States Toyota, which sold $14.5 billion worth of Toyotas in 2025, per Forbes.

The Friedkin family is also in talks to launch a new NHL team in Texas, with Houston and Austin being eyed as potential home bases, CultureMap reports. Bringing a professional hockey team to Houston would be a major boon for the city, which has been without one since the Houston Aeros folded in 2013.

Fertitta, 69, has a net worth of $12.3 billion and is the fourth richest Houstonian and the 110th richest American. Fertitta owns hospitality corporation Fertitta Entertainment and the NBA team Houston Rockets. He most recently purchased the WNBA's Connecticut Sun and plans to relocate them to Houston under the Houston Comets name in 2027. He also keeps himself busy as President Trump's ambassador to Italy.

There's also one new Houston-based billionaire making his debut on the Forbes 400: Houston Texans owner and CEO Cal McNair.

McNair, 64, took over as the principal owner of the NFL team after his late mother, Janice McNair, transferred her principal stake to him in 2024. Janice, who cofounded the Texans with her late husband Bob McNair, passed away in July 2026. She previously had an estimated net worth of $7.3 billion.

Cal McNair ranks as the 218th richest person in America with an estimated net worth of $7.7 billion.

Here's how the rest of Houston's billionaires fared on this year's list:

  • Houston pipeline heir Randa Duncan Williams ranks 124th with an estimated net worth of $11.7 billion. Fellow pipeline heirs Dannine Avara and Milane Frantz tie for 128th nationally. Each has an estimated net worth of $11.6 billion. Scott Duncan ties for No. 137 with an $11.3 billion estimated net worth.
  • Energy exploration chief exec George Bishop of The Woodlands ranks No. 380 with an estimated net worth of $4.5 billion. Last year: $4.7 billion.

Texas' richest billionaires
Walmart heiress Alice Walton, 76, who currently leads as the richest woman globally, is also the richest woman in America, the third-wealthiest person in Texas, and the richest Fort Worth resident for 2026.

Walton's net worth has grown by $12 billion since last year, bringing her current net worth to $118 billion. She is the only daughter of late Walmart cofounder Sam Walton, though she focuses her attention on other endeavors like the Crystal Bridges Museum of American Art and the Alice L. Walton School of Medicine in Bentonville, Arkansas. Forbes still lists her residence as Fort Worth. Walton is one of only 62 women billionaires on the Forbes 400 list, making up just 16 percent of the total list.

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This article first appeared on CultureMap.com.