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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With boost from Houston, Texas is the No. 1 state for economic development

governor's cup

Texas is on a 14-year winning streak as the top state for attracting job-creating business location and expansion projects.

Once again, Texas has claimed Site Selection magazine’s Governor’s Cup. This year’s honor recognizes the state with the highest number of economic development projects in 2025. Texas landed more than 1,400 projects last year.

Ron Starner, executive vice president of Site Selection, calls Texas “a dynasty in economic development.”

Among metro areas, Houston lands at No. 2 for the most economic development projects secured last year (590), behind No. 1 Chicago and ahead of No. 3 Dallas-Fort Worth.

In praising Houston as a project magnet, Gov. Greg Abbott cites the November announcement by pharmaceutical giant Lilly that it’s building a $6.5 billion manufacturing plant at Houston’s Generation Park.

“Growth in the Greater Houston region is a great benefit to our state’s economy, a major location for foreign direct investment and key industry sectors like energy, aerospace, advanced manufacturing, and life sciences,” Abbott tells Site Selection. “Houston is also home to one of the largest concentrations of U.S. headquarters for companies from around the world.”

In 2025, Fortune ranked Houston as the U.S. city with the third-highest number of Fortune 500 headquarters (26).

Texas retained the Governor’s Cup by gaining over 1,400 business location and expansion projects last year, representing more than $75 billion in capital investments and producing more than 42,000 new jobs.

Site Selection says Texas’ project count for 2025 handily beat second-place Illinois (680 projects) and third-place Ohio (467 projects). Texas’ number for 2025 represented 18% of all qualifying U.S. projects tracked by Site Selection.

“You can see that we are on a trajectory to ensure our economic diversification is going to inoculate us in good times, as well as bad times, to ensure our economy is still going to grow, still create new jobs, prosperity, and opportunities for Texans going forward,” Abbott says.

Houston e-commerce giant Cart.com raises $180M, surpasses $1B in funding

fresh funding

Editor's note: This article has been updated to clarify information about Cart.com's investors.

Houston-based commerce and logistics platform Cart.com has raised $180 million in growth capital from private equity firm Springcoast Partners, pushing the startup past the $1 billion funding mark since its founding in 2020.

Cart.com says it will use the capital to scale its logistics network, expand AI capabilities and develop workflow automation tools.

“This investment will strengthen our balance sheet and provide us with the flexibility to accelerate our strategic priorities,” Omair Tariq, CEO of Cart.com, said in a news release. “We’ve built a platform that combines commerce software with a scaled logistics network, and we’re just getting started.”

In conjunction with the funding, Springcoast executive-in-residence Russell Klein has been appointed to Cart.com’s board of directors. Before joining Springcoast, he was chief commercial officer at Austin-based Commerce.com (Nasdaq: CMRC). Klein co-led Commerce.com’s IPO, led the company’s mergers-and-acquisitions strategy and played a key role in several funding rounds.

“The team at Cart.com has demonstrated excellence in their ability to scale efficiently while continuing to innovate,” Klein said. “I’m excited to join the board and support the company as it expands its AI-driven capabilities, deepens enterprise relationships, and further strengthens its position as a category-defining commerce and fulfillment platform.”

Before this funding round, Cart.com had raised $872 million in venture capital and reached a valuation of about $1.6 billion, according to CB Insights. With the new funding, the startup has collected over $1 billion in just six years.

This is the income required to be a middle class earner in Houston in 2026

Cashing In

A new study tracking the upper and lower thresholds for middle class households across the nation's largest cities has revealed Houstonians need to make at least a grand more than last year to maintain their middle class status this year.

According to SmartAsset's just-released annual report, "What It Takes to Be Middle Class in America – 2026 Study," Houston households need to make anywhere from $42,907 to $128,722 to qualify as middle class earners this year.

Compared to 2025, Houstonians need to make $1,153 more per year to meet the minimum threshold for a middle class status, whereas the upper bound has stretched $3,448 higher. The median income for a Houston household in 2024 was $64,361, the study added.

SmartAsset's experts used 2024 Census Bureau median household income data for the 100 biggest U.S. cities and all 50 states and determined middle class income ranges by using a variation of Pew Research's definition of a middle class household, stating the salary range is "two-thirds to double the median U.S. salary."

In the report's ranking of the U.S. cities with the highest household incomes needed to maintain a middle class status, Houston ranked No. 80.

In the report's state-by-state comparison, Texas has the 24th highest middle class income range. Overall, Texas households need to make between $53,147 and $159,442 to be labeled "middle class" in 2026. For additional context, the median income for a Texas household in 2024 came out to $79,721.

"Often, the expectations that come with the term 'middle class' include reaching home ownership, raising kids, the comfort of modest emergency funds and retirement savings, and the occasional splurge or vacation," the report said. "And as the median household income varies widely across the U.S. depending on the local job market, housing market, infrastructure and other factors, so does swing the bounds on what constitutes a middle class income in America."

What it takes to be middle class elsewhere around Texas

Two Dallas-Fort Worth suburbs – Frisco and Plano – have some of the highest middle class income ranges in the country for 2026, SmartAsset found.

Frisco households need to make between $96,963 and $290,888 to qualify as middle class this year, which is the third-highest middle class income range nationwide.

Plano's middle class income range is the eighth highest nationally, with households needing to make between $77,267 and $231,802 for the designation.

Salary range needed to be a middle class earner in other Texas cities:

  • No. 28 – Austin: between $60,287 and $180,860
  • No. 40 – Irving: between $56,566 and $169,698
  • No. 44 – Fort Worth: between $55,002 and $165,006
  • No. 57 – Garland: between $50,531 and $151,594
  • No. 60 – Arlington: between $49,592 and $148,77
  • No. 61 – Dallas: between $49,549 and $148,646
  • No. 73 – Corpus Christi: between $44,645 and $133,934
  • No. 77 – San Antonio: between $44,117 and $132,352
  • No. 83 – Lubbock: between $41,573 and $124,720
  • No. 84 – Laredo: between $41,013 and $123,038
  • No. 89 – El Paso: between $39,955 and $119,864
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This article originally appeared on CultureMap.com.