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

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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Rice Brain Institute awards seed grants for dementia, Alzheimer’s research

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The recently established Rice Brain Institute awarded 12 seed grants last month to support research on dementia, Alzheimer’s disease, Parkinson’s disease and other neurological disorders.

The grants are part of the Rice DPRIT Seed Grant Program, which aims to help faculty members generate preliminary data, test and teams that would be supported under the Dementia Prevention and Research Institute of Texas.

The DPRIT was approved last year to provide $3 billion in state funding over a 10-year span for research on dementia prevention and other neurological conditions. It will be modeled after the Cancer Prevention and Research Institute of Texas (CPRIT), which has awarded nearly $4 billion in grants since 2008.

“DPRIT is a historic initiative with transformative impact potential and at Rice we are very well equipped to contribute to its mission and help make Texas a leader in brain health and innovation,” Behnaam Aazhang, a Rice professor of electrical and computer engineering and director of the Neuroengineering Initiative and the RBI, said in a news release.

The Rice DPRIT Seed Grant Program is supported by the RBI and the Educational and Research Initiative for Collaborative Health (ENRICH) office at Rice. Most of the funding came from Rice's Office of Research, with a contribution from Rice's Amyloid Mechanism and Disease Center, which also launched last year.

A number of the teams include collaborators from Houston's Texas Medical Center, including Baylor College of Medicine, University of Texas Medical Branch and the McGovern Medical School at UTHealth Houston.

The 12 teams are:

Keya Ghonasgi, assistant professor of mechanical engineering at Rice. Ghonasgi's research addresses the high risk of falls among people with different types of dementia and aims to develop a personalized, home-based fall-prevention approach using textile-integrated wearable sensors.
Luz Garcini, associate professor of psychological sciences at Rice, and Hannah Ballard, associate director of community and public health at the Kinder Institute for Urban Research at Rice. Garcini and Ballard's research looks at barriers and facilitators to early detection of Alzheimer’s disease in diverse, medically underserved urban communities and focuses on populations that experience late diagnosis, including Hispanic/Latino groups.
Lei Li, assistant professor of electrical and computer engineering at Rice, and Pablo Valdes, assistant professor of neurosurgery at UTMB. Li and Valdes' project develops a noninvasive, bedside imaging approach to monitor brain blood flow and oxygenation in patients recovering from stroke or brain surgery using photoacoustic imaging through a specialized transparent skull implant.
Cameron Glasscock, assistant professor of biosciences at Rice. Glasscock's project addresses repeat expansion disorders, such as Huntington’s disease and myotonic dystrophy, and focuses on stopping DNA instability before repeats reach a disease-causing threshold.
Raudel Avila, assistant professor of mechanical engineering at Rice. Avila's project focuses on everyday health factors such as nutrition, hydration and brain blood flow and how they influence brain aging long before symptoms of dementia appear.
Isaac Hilton, associate professor of bioengineering at Rice, and Laura Lavery, assistant professor of biosciences at Rice. Hilton and Lavery's project uses precise CRISPR-based gene regulation to target multiple genetic drivers of neuronal damage in Alzheimer’s.
Quanbing Mou, assistant professor of chemistry at Rice, and Qing-Long Miao, assistant professor of neurology at Baylor College of Medicine. Mou and Miao's project aims to develop a gene-regulation therapy for childhood absence epilepsy by restoring activity of the CACNA1A gene.
Momona Yamagami, assistant professor of electrical and computer engineering at Rice, and Christopher Fagundes, professor of psychological sciences at Rice. Yamagami and Fagundes' project addresses the physical and mental health challenges faced by spouses caring for partners with Alzheimer’s disease and related dementias and aims to develop algorithms to determine the optimal timing and frequency of supportive text messages.
Han Xiao, professor of chemistry at Rice. Xiao's project aims to improve the delivery of antibody therapies to the brain using a noninvasive, light-based approach that temporarily opens the blood–brain barrier.
Lan Luan, associate professor of electrical and computer engineering at Rice. Luan's project investigates how tiny blood-vessel injuries in the brain, known as microinfarcts, contribute to dementia.
Natasha Kirienko, associate professor of biosciences at Rice. Kirienko's project targets a shared cause of neurodegeneration, impaired mitochondrial cleanup, and aims to identify an existing antidepressant that could be repurposed to protect neurons in diseases like Alzheimer’s and Parkinson’s.
Harini Iyer, assistant professor of biosciences at Rice. Iyer's project will observe zebrafish to investigate how the brain’s primary immune cells become improperly activated in neurological disorders, leading to the loss of healthy neurons and cognitive impairment.

The RBI also named the first four projects to receive research awards through the Rice and TMC Neuro Collaboration Seed Grant Program in January. Read more about those projects here.

Report: These 10 jobs earn the biggest salary premiums in Texas

A move to Texas bolsters earnings for some, and a new SmartAsset study has revealed the top professions where the median annual earnings in the Lone Star State exceed the national median.

The report, "When it Pays to Work in Texas — and When It Doesn’t," published in April, analyzed over 700 occupations to determine which have the biggest "Texas premium" — meaning jobs where the price-adjusted median annual pay in Texas most exceeds the national median for the same occupation — and which jobs have the biggest “Texas penalty,” where the statewide median annual pay falls furthest below the national median. Salaries were sourced from the U.S. Bureau of Labor Statistics (BLS) and adjusted for regional price parity.

According to the report's findings, geoscientists have the biggest "Texas premium" and make a $159,903 median annual salary. Texas' salary for geoscientists is 61 percent higher than the national median for the same position (after adjusting for regional price parity).

"Texas’s large petroleum industry helps explain why employers in the state retain so many geoscientists," the report's author wrote. "In fact, the Lone Star State is home to more geoscientists than any other state except California."

There are more than 3,600 geoscientists working in Texas, SmartAsset said.

These are the remaining top 10 occupations with the biggest "Texas premiums" (salaries are price-adjusted):

No. 2 – Commercial pilots: $167,727 median Texas earnings; 37 percent higher than the national median
No. 3 – Sailors: $67,614 median Texas earnings; 36 percent higher than the national median
No. 4 – Aircraft structure assemblers: $83,519 median Texas earnings; 35 percent higher than the national median
No. 5 – Ship captains: $108,905 median Texas earnings; 27 percent higher than the national median
No. 6 – Nursing instructors (postsecondary): $100,484 median Texas earnings; 26 percent higher than the national median
No. 7 – Tax preparers: $63,321 median Texas earnings; 25 percent higher than the national median
No. 8 – Chemists: $104,241 median Texas earnings; 24 percent higher than the national median
No. 9 – Health instructors (postsecondary): $128,680 median Texas earnings; 22 percent higher than the national median
No. 10 – Engineering instructors (postsecondary): $129,030 median Texas earnings; 22 percent higher than the national media

The careers where Texas workers earn less

SmartAsset said an editor is the Texas profession where workers earn the furthest below the median for the same occupation elsewhere in the U.S. Not to be confused with film and video editors, BLS defines editors as those who "plan, coordinate, revise, or edit written material" and "may review proposals and drafts for possible publication."

The study found editors make a price-adjusted median wage of $29,710, which is 61 percent lower than the national median for the same position, and there are nearly 8,200 editors in Texas.

It's worth noting that the salaries for editors may be skewed by the fact that there are not major publications in rural areas of Texas, and other professions may also have financial deviations for similar reasons.

Several healthcare jobs also appear to have the worst penalties in Texas compared to elsewhere in the country. Home health aides are the second-worst paying professions in the state, making a median wage of $24,161.

"More home health aides work in Texas than in nearly any other state, with only California and New York employing more," the report said. "However, the more than 300,000 Texans in this occupation earn median annual pay that is about 31 percent below the national median, after adjusting for regional price parity.

SmartAsset clarified that pay penalties are not consistent "across the board" for other healthcare occupations in Texas.

"For physical therapy assistants, occupational therapy assistants, and postsecondary nursing instructors, Texas may be an especially strong place to work, with these occupations offering 'Texas premiums' of between 17 percent and 26 percent," the study said.

These are the remaining top 10 occupations where median annual earnings in Texas fall furthest below the national median for the same occupation:

No. 3 – Cardiovascular technicians: $49,382 median Texas earnings; 27 percent lower than the national median
No. 4 – Semiconductor processing technicians: $38,295 median Texas earnings; 25 percent lower than the national median
No. 5 – Tutors: $30,060 median Texas earnings; 25 percent lower than the national median
No. 6 – Control and valve installers: $56,496 median Texas earnings; 24 percent lower than the national median
No. 7 – Mental health social workers: $46,109 median Texas earnings; 23 percent lower than the national median
No. 8 – Clinical psychologists: $74,449 median Texas earnings; 22 percent lower than the national median
No. 9 – Producers/directors: $65,267 median Texas earnings; 22 percent lower than the national median
No. 10 – Interpreters/translators: $46,953 median Texas earnings; 21 percent lower than the national median

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This article originally appeared on CultureMap.com.

Houston rises in 2026 ranking of best U.S. cities to start a business

Best for Biz

Houston has reaffirmed its commitment to a business-friendly environment and now ranks as the 26th best large U.S. city for starting a business in 2026. The city jumped up eight places after ranking 34th last year.

WalletHub's annual report compared 100 U.S. cities based on 19 relevant metrics across three key dimensions: business environment, access to resources, and costs. Factors that were analyzed include five-year business survival rates, job growth comparisons from 2020 and 2024, population growth of working-age individuals aged 16-64, office space affordability, and more.

Florida cities locked out the top five best places in America for starting a new business: Tampa, Orlando, Jacksonville, Hialeah, and St. Petersburg.

Houston's business environment ranked as the 19th best in the country, and the city ranked 51st in the "business costs" category. However, the city lagged behind in the "access to resources" ranking, coming in at No. 72 overall. This category examined metrics such as Houston's working-age population growth, the share of college-educated individuals, financing accessibility, the prevalence of investors, venture investment amounts per capita, and more.

"From the Gold Rush and the Industrial Revolution to the Internet Age, periods of innovation have shaped our economy and driven major societal progress," the report's author wrote. "However, the past few years have been particularly challenging for business owners in the U.S., due to factors such as the COVID-19 pandemic, the Great Resignation and high inflation."

Earlier this year, WalletHub declared Texas the third-best state for starting a business in 2026, and several Houston-area cities have seen robust growth after being recognized among the best career hotspots in the U.S. Entrepreneurial praise has also been extended to five local companies that were named the most innovative companies in the world, and six powerhouse female innovators that made Inc. Magazine's 2026 Female Founders 500 list.

Texas cities with strong environments for new businesses
Multiple cities in the Dallas-Fort Worth Metroplex can claim bragging rights as the best Texas locales for starting a new business. Dallas ranked highest overall — appearing 11th nationally — and Irving landed a few spots behind in the 16th spot. Arlington (No. 23), Fort Worth (No. 30), Plano, (No. 35), and Garland (No. 65) followed behind.

Only six other Texas cities earned spots in the report: Austin (No. 24), Lubbock (No. 36), Corpus Christi (No. 39), San Antonio (No. 64), El Paso (No. 67), and Laredo (No. 76).

Austin tied with Boise, Idaho and Fresno, California for the highest average growth in the number of small businesses nationally, while Corpus Christi and Laredo topped a separate list of the U.S. cities with the most accessible financing.

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