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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Elon Musk's SpaceX files initial paperwork to sell shares to the public

Incoming IPO

Elon Musk's space exploration company has filed preliminary paperwork to sell shares to the public, according to two sources familiar with the filing, a blockbuster offering that would likely rank as the biggest ever and could make its founder the world's first trillionaire.

A SpaceX IPO promises to be one of the biggest Wall Street events of the year, with several investment banks lining up to help raise tens of billions to fund Musk's ambitions to set up a base on the moon, put datacenters the size of several football fields in orbit and possibly one day send a man to Mars.

The sources spoke on condition of anonymity because they were not authorized to talk publicly about the confidential registration with the Securities and Exchange Commission.

SpaceX did not respond immediately to a request for comment.

Exactly how much SpaceX plans to raise has not been disclosed but the figure is reportedly as much as $75 billion. At that level, the offering would easily eclipse the $29 billion that Saudi Aramco raised in its IPO in 2019.

The offering, coming possibly in June, could value all the shares of SpaceX at $1.5 trillion, nearly double what the company was valued in December when some minority owners sold their stakes, according to research firm Pitchbook, before an acquisition that increased its size.

Musk owns 42% of the SpaceX now, according to Pitchbook, though that figure will change with the IPO when new owners are issued shares. In any case, he is likely to pierce the trillion dollar mark because he is already close. Forbes magazine estimates Musk's net worth at roughly $823 billion.

In addition to making reusable rockets to hurl astronauts and hardware into orbit, SpaceX owns Starlink, the world’s largest satellite communications company. The company also recently brought under its roof two other Musk businesses, social media platform X, formerly Twitter, and artificial intelligence business, xAI, in a controversial transaction because both the seller and the buyer were controlled by him.

SpaceX has become the biggest commercial launch company in its industry, responsible for sending payloads into orbit for customers across the globe, but has also benefited from big taxpayer spending. That has raised conflicts of interest issues given that Musk was the biggest donor to President Donald Trump's campaign and is still a big backer.

In the past five years, SpaceX won $6 billion in contracts from NASA, the Defense Department and other U.S. government agencies, according to USAspending.gov.

Among current SpaceX owners is Donald Trump Jr, the president's oldest son. He owns a shares through 1789 Capital. That venture capital firm made him a partner shortly after his father won the presidency for a second time and has been buying up federal contractors seeking to win taxpayer money ever since.

The White House and Trump himself have repeatedly denied there are any conflicts of interest between his role as president and his family's businesses.

8+ can't-miss Houston business and innovation events in April

where to be

Editor’s note: Houston's weeklong innovation festival kicks off April, followed by Rice University's globally recognized pitch competition returning for its 26th year. Plus, find coworking pop-ups, industry meetups, pitch battles and even a crawfish boil on the calendar. Here’s what not to miss and how to register. Please note: this article might be updated to add more events.

March 30-April 4 — H-Town Roundup

Celebrate innovation, entrepreneurship and collaboration at Houston Exponential's sixth-annual H-Town Roundup. During the free event series, previously known as Houston Tech Rodeo, attendees can expect insightful talks, workshops and networking events at venues across the city.

This event began March 30. Register here.

April 2 — Industrious Coworking Day

Enjoy a complimentary day of cowering at Industrious and network with professionals at the Ion. Breakfast, snacks, wifi and workspace tours are included. Following the cowering day, Industrious will host happy hour at Second Draught from 4-6 p.m.

This event is Thursday, April 2, from 8:30 a.m.-5 p.m. at the Ion. Register here.

April 2 — Technology Summit for Women

The fourth annual Women in Tech Cummil will feature speakers across three core tracks: Transformation + Digital strategy, Cyber + Risk + Resilience, and AI in Practice. Pearl Chu, director of technical domains and university relations at SLB, will give the opening remarks. Other panelists come from CenterPoint Energy, BP, Technip Energies and other leading companies.

This event is Thursday, April 2, from 2-5 p.m. at the Ion. Register here.

April 8 — Veterans Business Battle

Hear pitches from veterans and entrepreneurs as they compete for more than $10 million in investments at Rice Businesses' 12th annual Veterans Business Battle. This year, the two-day event will also feature a Small Business Expo, which invites Houston-based, veteran-owned businesses to participate in education, networking and the opportunity to showcase their business. Moonshots Capital and Mercury Fund will also host a fireside chat.

This event begins Wednesday, April 8, at 11 a.m. at the Ion. Click here to register.

April 9-11 — Rice Business Plan Competition

The Rice Alliance for Technology and Entrepreneurship will host the 26th annual Rice Business Plan Competition this month. Forty-two student-led teams from around the world, including one team from Rice, will present their plans before more than 300 angel, venture capital, and corporate investors to compete for more than $1 million in prizes.

This event begins Thursday, April 9. Find more information here.

April 10 — BioHouston Chili Cookoff

Connect with Houston's life sciences community at BioHouston's 21st annual chili cookout. This event is geared toward startup founders, researchers and industry veterans alike.

This event is Friday, April 10, from noon-4 p.m. at Bayou City Event Center. Register here.

April 14 — Mercury Fund Day at the Ion: Agentic Commerce

Don’t miss the latest installment of Mercury Fund Day at the Ion, previously known as Software Day. The recurring monthly event features office hours (by application), a keynote and networking opportunities. This month's topic focuses on agentic commerce.

This event is Tuesday, April 14, from 3:30-7 p.m. at the Ion. Register here.

April 19 – UH Energy Industry Crawfish Boil

Head to the UH Cullen College of Engineering Green Space for the 35th annual UH Energy Industry Crawfish Boil. The event will include a student showcase, STEM activities, a kids zone, live music, networking and, of course, crawfish. Proceeds from the event will support the multidisciplinary capstone fund that aims to increase professional readiness for Cullen College engineering and technology students.

This event is Sunday, April 19, from 1-5 p.m. at the Cullen College of Engineering Green Space. Find more information here.

April 24 — Rice Business Healthcare Conference

Leading experts, innovators and the next generation of healthcare leaders will converge at the Rice Business Healthcare Conference. Hosted by the Rice Business Healthcare Association, the conference will explore AI's potential impact on the sector.

This event is Friday, April 24, from 8 a.m.-2 p.m. at McNair Hall on Rice University's campus. Find more information here.

Houston unicorn closes $421M to fuel first phase of flagship energy project

Heating Up

Houston geothermal unicorn Fervo Energy has closed $421 million in non-recourse debt financing for the first phase of its flagship Cape Station project in Beaver County, Utah.

Fervo believes Cape Station can meet the needs of surging power demand from data centers, domestic manufacturing and an energy market aiming to use clean and reliable power. According to the company, Cape Station will begin delivering its first power to the grid this year and is expected to reach approximately 100 megwatts of operating capacity by early 2027. Fervo added that it plans to scale to 500 megawatts.

The $421 million financing package includes a $309 million construction-to-term loan, a $61 million tax credit bridge loan, and a $51 million letter of credit facility. The facilities will fund the remaining construction costs for the first phase of Cape Station, and will also support the project’s counterparty credit support requirements.

Coordinating lead arrangers include Barclays, BBVA, HSBC, MUFG, RBC and Société Générale, with additional participation from Bank of America, J.P. Morgan and Sumitomo Mitsui Trust Bank, Limited, New York Branch.

“As demand for firm, clean, affordable power accelerates, EGS (Enhanced Geothermal Systems) is set to become a core energy asset class for infrastructure lenders,” Sean Pollock, managing director, project Finance at RBC Capital Markets, said in a news release. “Fervo is pioneering this step change with Cape Station, a vital contribution to American energy security that RBC is proud to support.”

The oversubscribed financing marks Cape Station’s shift from early-stage and bridge funding to a long-term, non-recourse capital structure, according to the news release.

“Non-recourse financing has historically been considered out of reach for first-of-a-kind projects,” David Ulrey, CFO of Fervo Energy, said in a news release. “Cape Station disrupts that narrative. With proven oil and gas technology paired with AI-enabled drilling and exploration, robust commercial offtake, operational consistency, and an unrelenting focus on health and safety, we have shown that EGS is a highly bankable asset class.”

Fervo continues to be one of the top-funded startups in the Houston area. The company has raised about $1.5 billion prior to the latest $421 million. It also closed a $462 million Series E in December.

According to Axios Pro, Fervo filed for an IPO that would value the company between $2 billion and $3 billion in January.

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This article first appeared on EnergyCapitalHTX.com.