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

.

Saranas Inc. is testing its technology that can detect and track internal bleeding complications. Getty Images

Houston medical device company heads to clinical trials following recent $2.8 million raise

HEalth tech

A Houston-based medical device startup is on a twofold mission to reduce healthcare costs and improve the safety of complex medical procedures involving blood vessels.

Saranas Inc. currently is testing its Early Bird Bleed Monitoring System, which is designed to detect and track bleeding complications related to endovascular procedures. These medical procedures treat problems, such as aneurysms, that affect blood vessels.

"What attracted me to Saranas is that our solution has the potential to meaningfully reduce serious bleeding complications that worsen clinical outcomes and drive up healthcare costs," says Zaffer Syed, president and CEO of Saranas. "In addition, our device may support access of important minimally invasive cardiac procedures by allowing them to be performed more safely."

Dr. Mehdi Razavi, a cardiologist with the Texas Heart Institute at Houston's Texas Medical Center, invented the device. It's being tested by the institute and other medical facilities in the U.S. As many as 100 patients will participate in the clinical trial, which is expected to last several months.

If all goes well, the U.S. Food and Drug Administration will approve Early Bird in 2019, Syed says. Then, the device would be made widely available to medical facilities across the country.

In May, Saranas said it received $2.8 million in funding from investors to enable testing of Early Bird. In all, the startup has collected $12 million from investors. A month after the funding announcement, Saranas was one of 50 startups chosen for the MedTech Innovator program, which nurtures medical technology companies.

As explained by the Texas Heart Institute, the Early Bird employs a sheath — a plastic tube that helps keep arteries and vessels open — embedded with sensors that measure the electrical resistance across a blood vessel. When the Early Bird senses a change in the electrical resistance, medical professionals get audible and visual notifications about potential internal bleeding. If detected early, this bleeding can be halted or prevented.

"There is a risk of bleeding that occurs when some of these coronary interventions are performed through the femoral artery, which is in the upper thigh," Syed says.

In a release, Texas Heart Institute cardiologist Dr. Joggy George says internal bleeding "remains the Achilles' heel" of advances in noninvasive endovascular procedures.

Syed says there's an underappreciation for how often bleeding occurs during nonsurgical procedures that provide access to a patient's blood vessels. Each year, doctors perform these procedures on more than 20 million patients in the U.S.; of those, about 1 million experience severe complications from bleeding. Those complications can lead to longer, more expensive hospital stays along with a higher risk of death.

Initially, Saranas is targeting high-risk endovascular procedures done with large sheaths, rather than endovascular procedures performed with sheaths of all sizes, Syed says.

Syed took the helm of Saranas in February 2017. He's spent nearly 20 years in the medical device industry, including four years at Bellaire-based OrthoAccel Technologies Inc.

For the time being, Syed is one of just a handful of employees at Saranas, which was founded in 2013 and has benefited from its affiliation with the Texas Medical Center Innovation Institute. Syed expects to grow the Saranas team in 2019 once the Early Bird gains clearance from the FDA.

During his tenure in the medical device sector, Syed has been "keenly interested" in bringing impactful innovations to the market, such as the Early Bird device.

"It is especially important to me that such innovation not only improves health outcomes but also aims to drive down healthcare costs," he says. "We are in a healthcare environment where if you don't have a health economic benefit coupled with a clinical outcome, it is very challenging to get adoption of new technology."

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.

Ad Placement 300x100
Ad Placement 300x600

CultureMap Emails are Awesome

Property Showcase

5 Houston deep tech startups pushing the boundaries of their industries

meet the finalists

Houston has long been at the forefront of innovation, from NASA’s Johnson Space Center to its startup ecosystem using technology to disrupt industries.

As part of the 2026 Houston Innovation Awards, our Deep Tech Business category will honor an innovative startup providing technology solutions based on substantial scientific or engineering challenges, including those in the AI, robotics and space sectors.

Five deep tech companies have been named finalists for the 2026 award.

Read more about these businesses, their founders and their breakthrough technologies below. The 2026 winners will be announced on InnovationMap.com in mid-November.

Casimir

Battery tech startup Casimir develops semiconductor chips that produce continuous electrical power straight from the quantum vacuum, without the need for a battery, cord or external charge source. The company is targeting commercialization for its first-generation MicroSparc chip by 2028.

Harold “Sonny” White founded Casimir in 2023 after nearly two decades at NASA. The company emerged from stealth with a $12 million seed round in 2026. It was also awarded an STTR Phase I contract from the U.S. Space Force's SpaceWERX to support the development of the company's solid-state generator for potential use by the Department of the Air Force earlier this year.

FocisAI

Artificial intelligence startup FocisAI helps refinery owner-operators unlock actionable insights from 3D scans and images.

FocisAI was founded by CEO Tyler Wooten, COO Colin Snell and CTO Kyle Snell in 2026. It is a member of Greentown Labs and launched a seed round in September, which is expected to close by the end of the year, according to the company's application. It has rolled out 10 pilot programs and is looking to move into recurring, facility-scale deployments and scale its team in Houston this year.

Machine Saver Inc.

Industrial tech startup Machine Saver Inc. builds wireless and wired vibration and proximity sensors to tell heavy industry when a machine is about to fail. The company's technology runs on an 8-plus-year battery life and helps operators reduce downtime, improve maintenance and extend equipment life.

Machine Saver was founded by CEO Colton Bach and Quentin Bach in 2013. Its customers and partners include Houston Methodist, Blue Bell, Genemco, as well as energy and heavy industry, food and beverage, and cold chain companies, according to its application. The company is raising a Series A.

Square Robot

Energytech startup Square Robot develops and operates submersible inspection robotics that inspect aboveground storage tanks while they remain in service. The robots reduce downtime and costs, improve worker safety and limit hydrocarbon emissions.

Square Robot launched its Houston office in 2019 and closed a Series B in 2025. It plans to complete its first U.S. Navy demonstrator tank in November and is also developing real-time inspection software.

Venus Aerospace

Spacetech company Venus Aerospace is developing a high-thrust rotating detonation rocket engine (RDRE) that replaces the subsonic combustion used in conventional rocket engines. The RDRE is a compact, simpler engine that can deliver up to 15 percent greater efficiency for defense and space applications. It completed its first U.S. flight test of the engine last summer.

Venus Aerospace was founded in 2020 by CEO Cassie Duggleby and CTO Andrew Duggleby. It raised a $20 million Series A in 2022 and $42 million Series A2 in 2025. It closed a $91 million Series B earlier this year and expanded its leadership team. The company is working toward longer-duration and higher-thrust testing and advancing its flight program.

Houston leads U.S. with the biggest surge in millionaire renters

Rent Report

The number of millionaire renters and homeowners in the U.S. has surged over the last five years, and Houston has soared ahead of the rest with the largest growth rate among these affluent renter households.

Houston leads the nation with the No. 1 increase in millionaire renters from 2020 to 2024, a new RentCafe study found. The number of these wealthy households increased from 18 to 232 over the last five years, representing a 1,189 percent growth rate.

"The pandemic accelerated the shift as remote work pushed the wealthy to relocate to lower-tax metros like Houston, where millionaire renters grew 13-fold, versus 3.9-fold for owners," the report said. "Granted, 232 households is still a tiny fraction of the Houston metro’s roughly 2.7 million households, but the growth rate far outpaces any other major metro."

Nationwide, the number of millionaire renter households grew 229 percent from 2020 to 2024, outpacing the 193 percent growth rate among millionaire homeowners.

Dallas was the only other Texas metro to crack the top 10. The number of millionaire renter households in North Texas has more than quintupled, from just 30 in 2020 to 165 in 2024. That represents a growth rate of 450 percent, which — surprisingly — is only the eighth highest nationwide.

But when it comes to the largest populations of millionaire renters, New York City and San Francisco still lead the way. New York claimed the No. 1 spot with nearly 7,300 millionaire renters living in the city in 2024. Houston ranked 12th on that list.

Elsewhere in Texas, Austin and Dallas ranked as the 16th and 17th, respectively, for the largest population of millionaire renters. There were 206 millionaire renters living in Austin in 2024, and 165 in Dallas.

This is who the typical millionaire renter is
The report also revealed a surprising statistic about the typical millionaire renter in the U.S. — a lot of them are millennials working in "white-collar, high-earning fields."

"Nearly half (49 percent) of millionaire renters are Millennials, and the number of affluent Millennial renter households surged 392 percent during the five-year period," the report said. "Gen X follows with 33 percent of millionaire Gen X households renting after increasing by 147 percent."

The report continued, "Although Gen Z still represents a small share of millionaire renters (just 2 percent of the total), no generation has expanded faster: Gen Z millionaire renter households leaped from fewer than a dozen to more than 400 — a tiny cohort today, but one that was virtually nonexistent five years ago."

The top three most common professions for millionaire renters are chief executives, software developers, and managers, the report additionally found. In Houston, the surge of wealthy newcomers are mostly executives, professional athletes, and entertainers.

"These roles tend to generate steady, substantial income without necessarily tying workers to one location, making renting a practical fit, rather than a financial necessity," the report said.

Hotspots for millionaire homeowners
In RentCafe's separate list comparing the top 10 most popular U.S. metros for millionaire homeowners, Houston ranked 12th nationally with 4,374 millioniare homeowners living in the metro as of 2024. These wealthy Houstonians are most likely working as chief executives, physicians, managers, and lawyers and judges.

Houston has already proven to be a hotspot for millennial homebuyers, and the latest RentCafe data says millennials make up 19 percent of all millionaire homeowners in the U.S. Gen Xers and Baby Boomers still maintain the largest shares of millionaire homeowners nationwide, at 45 and 33 percent, respectively.

Dallas (No. 10) and Austin (No. 20) also appeared among the hottest metros for millionaire homeowners.

Only one Texas city appeared among RentCafe's list of the 20 fastest-growing metros for millionaire homeowners: College Station ranked 13th nationwide with a growth rate of 1,329 percent. From 2020-2024, the number of millionaire homeowners residing in College Station grew from 14 to 200.

---

This article originally appeared on CultureMap.com.

Houston ranks high on best cities for small-business expansion report

business growth

For small businesses looking to expand, Houston might be the right place.

Among 56 major U.S. metros, Houston grabbed the No. 6 spot on a new list of the metros boasting the strongest environments for small-business expansion.

A 2025 report from the state comptroller’s office showed roughly 970,000 small businesses operate in the 13-county Gulf Coast region. The region includes the majority of the Houston metro area.

“Whether it’s a family-owned shop on Main Street or a fast-growing startup, small businesses power our state’s economic engine, create opportunity, and strengthen the character of every Texas community,” Kelly Hancock, who was interim state comptroller when the report was released, said in a press release.

Business lending platform Clarify Capital analyzed five factors to develop the list: job growth, business entry and exit, net job creation, and unemployment.

Overall, the Nashville area claimed the No. 1 spot on the list. Other major Texas metros also cracked the top 10, including Austin at No. 3 and Dallas-Fort Worth at No. 7.

“The highest-ranking metros combine labor-market momentum with steady business formation and relatively favorable local employment conditions,” Clarity Capital says.

The Houston metro ranked sixth for job growth, 11th for business entry rate, 38th for business exit rate, second for net job creation rate, and 50th for unemployment rate.

“For business owners, the ranking is a starting point rather than a guarantee,” Clarify Capital says. “Local demand, competition, operating costs, and access to capital still shape whether an expansion works.”

“Building enough cash-flow room for hiring, equipment, and unexpected expenses can help small and midsize business owners take advantage of a strong market without stretching the business too thin,” the company adds.

Of course, money fuels small-business expansion in the Houston area or anywhere else.

According to an analysis of SBA loan data by feasibility consulting firm MMCG, the Houston metro area saw 1,685 approvals for 7(a) loans and 101 approvals of 504 loans in the federal government’s 2025 budget year. The approval numbers for both loan categories increased from the previous year.

Altogether, the 7(a) and 505 loans exceeded $1 billion.

The data from the U.S. Small Business Administration suggests small-business expansion may be on the rise in the Houston area.

Further potential evidence of small-business expansion in the Houston area: The region experienced a 92 percent rise in account applications from 2024 to 2025 submitted to Bluevine, a small-business banking platform. The Houston metro ranked fifth for the number of Bluevine small-business applications in 2025.

View All Listings