Report finds Houston is short on health care workers

what's up docs

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."

Ad Placement 300x100
Ad Placement 300x600

CultureMap Emails are Awesome

Property Showcase

UH lands $4M NIH grant to study early signs of autoimmune disease

NIH funding

The University of Houston recently received a $4 million National Institutes of Health grant to support a 10-year longitudinal study to identify the earliest biological markers of autoimmune disease.

Led by Chandra Mohan, the Hugh Roy and Lillie Cranz Cullen Endowed Professor of Biomedical Engineering, the study aims to examine what causes Systemic Autoimmune Rheumatic Diseases (SARDs) and to identify targets for future treatments. The study will be carried out in collaboration with Dr. Karen Costenbader at Harvard Medical School, Boston.

SARDs include conditions like rheumatoid arthritis, systemic lupus erythematosus, Sjögren’s syndrome and systemic sclerosis—all are considered chronic diseases currently without a cure. Autoimmune diseases affect over 30 million people globally, according to UH.

SARDs occur when the body’s immune system attacks healthy, non-threatening tissues and organs. According to UH, in these diseases, the body often attacks nuclear antigens, creating anti-nuclear autoantibodies, which can be early detection signs for SARDs in more than 50 percent of patients, Mohan says.

Researchers will study blood samples and environmental exposure over the 10 years to better understand anti-nuclear autoantibodies.

“Collectively, these studies will help identify the genetic, environmental and cellular factors that are operative at the two steps of SARD development, namely the emergence of anti-nuclear autoantibodies and disease onset,” Mohan said in a news release. “ More importantly, these studies will highlight functional molecular pathways and mechanisms that may be operative at each step."

Mohan predicts that looking at SARDs’ shared characteristics, rather than each disease individually, could help identify more treatment methods.

“Individual SARDs have been examined in silos without an attempt to discern shared underlying features at the molecular level,” he added in the release. “Current understanding of the initial (and likely shared) origins of SARDs is only rudimentary but urgently needed to develop means for prevention and treatment.”

Earlier this year, UH also received an $11 million NIH grant to conduct a first-of-its-kind study of early language development in children ages 18 to 24 months. Read more here.

New Texas Stock Exchange officially begins trading in Dallas

Welcome to Y'all Street

Two-step aside, New York Stock Exchange and Nasdaq. The Dallas-based Texas Stock Exchange, nicknamed Y’all Street, just kicked off live trading with five stocks — and lots of Lone Star ambition.

“The Texas Stock Exchange aims to revitalize competition for [stock] issuers, establish the premier venue for listings, and create a world-class trading platform for all market participants,” the exchange says in a fact sheet.

The exchange — whose Texas-influenced nickname is a nod to New York City’s Wall Street — has collected at least $275 million in investments. The roughly 90 financial backers of TXSE include Bank of America, BlackRock, Charles Schwab, Citadel Securities, Dell Family Office, Fortress, Goldman Sachs, and JPMorgan Chase.

Representatives of TXSE couldn’t be reached for comment. On its website, the exchange calls itself “the most well-capitalized equities exchange to ever be approved” by the U.S. Securities and Exchange Commission (SEC).

Not to be outdone, NYSE has launched Dallas-based NYSE Texas and Nasdaq has expanded its presence in Dallas.

Y’all Street adds to Dallas-Fort Worth’s rising status as a major hub for financial services, with The Wall Street Journal naming North Texas the country’s second biggest financial hub after New York City.

“A homegrown national exchange means more jobs, more investment, and more growth opportunities for businesses and communities across the Lone Star State,” Gabriela von zur Muehlen, senior vice president and chief policy officer at the Texas Association of Business, told The Texas Tribune.

Bulent Temel, an associate professor of practice in economics at the University of Texas at San Antonio, told Texas Standard that TXSE “is going to boost the credibility of the Texas economy.”

Texas’ estimated gross domestic product (GDP), a yardstick for the size of an economy, climbed to a record-setting $2.9 trillion in 2025, making it the state with the second highest GDP after California. DFW’s estimated GDP in 2023 stood at $744.6 billion, eclipsing the GDP of many countries.

“The center of gravity for American capitalism is now headquartered in the Boom Belt,” Abbott proclaimed in April, referring to an 11-state region (including Texas) in the South and Southeast that’s seeing tremendous economic and population growth. “The Texas Stock Exchange is the natural extension of that capitalism. It ensures that capital markets will reflect the quadrant that is driving American growth.”

---

This article originally appeared on CultureMap.com.

Orion vehicle manager reflects on Artemis II, looks to 2028 moon mission

Q&A

Humanity is finally headed back to the moon after more than half a century. This year's launch of the Artemis II mission in the Orion spacecraft put four crew members in lunar orbit and tested the new ship developed by Lockheed Martin.

Everything went smoothly, safely returning astronauts home, but there is always room to improve. InnovationMap chatted via email with Orion vehicle manager Branelle Rodriguez, shortly after a talk at The Ion, for insight on how Orion might perform in the future as the next lunar landing approaches in early 2028.

InnovationMap: How satisfied are you with the way Orion operated on this past mission?

Branelle Rodriguez: Orion performed exceptionally well during Artemis II, successfully demonstrating critical spacecraft capabilities, including life support systems, displays and controls, and executing manual piloting operations. Artemis II brought humans back to the moon, achieving key exploration and scientific imagery, while validating systems essential for future Artemis missions.

IM: What is the most important thing you learned about improving Orion for the next mission?

BR: The Artemis II mission provided invaluable insights into crew operations and spacecraft performance in a deep-space environment. With every mission, NASA applies lessons learned to continuously improve Orion’s operations, validate design and ensure mission readiness. Artemis II offered our first opportunity to evaluate several new systems and gain a deeper understanding of what it is like for astronauts to live and work inside the spacecraft. The operational, technical and human factors data collected are being integrated across the program to refine future missions, reduce risk and enhance overall mission success.

IM: How has Orion helped the mission to explore space?

BR: Orion is one of NASA’s foundational elements for human deep space exploration—not only supporting the mission but serving as a core component of it. It is currently the only spacecraft capable of carrying crew on deep space missions and returning them safely to Earth from the high speeds required from the vicinity of the moon. No other spacecraft has the technology to endure the extremes that come with human deep-space travel, such as advanced environmental and life support, navigation, communications, radiation shielding, and the world’s largest ablative heat shield to protect the astronauts during reentry into Earth’s atmosphere. Orion has already taken astronauts to explore space farther than ever before—252,756 miles from Earth— and will carry crews to the moon on future missions to explore the lunar South Pole region. The astronauts’ observations, samples, and data collected on these future missions will expand our understanding of our solar system and home planet.

---

This conversation has been edited for brevity and clarity.

View All Listings