How Are Texas Hospitals Approaching Demand in the Healthcare Workforce?

A Growing State, A Growing Need

Texas continues to lead the nation in both population and job growth. More people are moving to the state for its economic opportunity, business-friendly environment and quality of life. But rapid growth creates a challenge for the state’s healthcare system to keep pace – like much of the country, Texas faces shortages of physicians, nurses and other healthcare professionals. However, the rest of the country doesn’t face the same dual threat of addressing an existing shortage compounded by a rapidly growing population.

Along with that rapid growth, Texas must manage meeting the needs of millions of existing residents, including a growing older population that increasingly relies on healthcare services. As a major component of the healthcare safety net providing emergency or acute care, Texas hospitals have no choice but to meet that demand and supply the quality care communities deserve.

Some estimates indicate that over the past decade, Texas has added nearly 30,000 people per month to its population. Just maintaining current staffing levels could therefore require roughly 2,100–2,700 additional healthcare workers every month statewide.

The Ripple Effects of Workforce Gaps

How many people does it take to care for one patient in a hospital?

The answer depends on the patient’s needs, but as THA Vice President, Advocacy & Public Policy Benjamin Williams observes, “hospitals need more than just the employees that patients see. Behind every hospital stay is a complex team of clinicians, technicians and support staff keeping care running 24 hours a day. There is a chain of trained individuals, and each one must do their job to ensure quality care for all patients.” Physicians, nurses, pharmacists, respiratory therapists, laboratory professionals, radiology staff, food service workers, environmental services teams and many others contribute to patient care.

When shortages emerge in one profession, the impact rarely remains isolated. If a radiology technologist’s position goes unfilled, imaging services may slow. If there are not enough technicians, other team members may be required to absorb additional responsibilities, and the chain breaks down. Care may have to be delayed or postponed to maintain manageable workloads. Further, persistent staffing gaps can increase reliance on expensive contract labor, create operational strain and negatively impact workforce retention.

Hospitals are taking this challenge into their own hands. Approaches such as “grow-you-own” and “earn-while-you-learn” allow hospitals to invest in their existing workforce, to train them and retain them as the future workforce. Other strategies are to develop local partnerships tailored to their communities’ needs, such as partnering with school districts and higher education institutions to introduce students to healthcare careers earlier. Others are creating apprenticeship programs or career ladder opportunities that help employees advance into higher-skilled roles.

For instance, in 2024, Memorial Hermann Health System, in partnership with Aldine Independent School District in Houston, opened Health Education and Learning (HEAL) High School, “informed by Memorial Hermann’s needs, Gulf Coast labor market trend data and an analysis of earnings and growth potential, the school will offer five pathways: nursing, rehabilitation, pharmacy, imaging, and non-clinical administration.”

Hospitals require a greater workforce pool to hire from and are increasingly investing hospital resources into the development of this pool. The greater the partnership with the State of Texas and local communities, the stronger this pool will be.

The Nursing Pipeline

Take nurses, often the backbone of any hospital – 2024 state data projects a deficit of 56,371 RNs by 2036, with an incremental, majority demand in inpatient hospitals. The persistent work to keep up with heavy workloads is leaving a growing number of nurses burnt out or leaving the profession. Nationwide, the nursing shortage resulted in less nursing faculty and reduced clinical capacity for nursing programs, which has produced fewer graduating nurses, perpetuating the cycle.

Texas has made phenomenal strides in answering the call, supplementing 23 new nursing education programs between 2020 and 2024 statewide, largely thanks to an influx of program and professional funding and growth in available clinical spaces. This includes programs like the Nurse Loan Repayment Assistance program and innovative initiatives like the Supplemental Nursing Academic Practice Partnership Initiative (SNAPPI).

SNAPPI is a Texas-born method testing new approaches to clinical preceptorships that could help educate more nurses while maintaining training quality. SNAPPI expands clinical training capacity by allowing registered nurses to teach students in the units where they already practice. Through dedicated scheduling and compensation support, hospitals integrate education into nurses’ regular responsibilities, making it possible to grow the next generation of nurses without pulling experienced clinicians away from patient care. Leaders see these efforts as examples of locally developed solutions that could eventually be scaled to other communities.

“Healthcare is one of the few industries where employees can continually build on their education and experience throughout their careers,” Williams says. “The opportunities for advancement are virtually limitless.”

Preparing Physicians

Increasingly, hospitals are concerned about shortages among specialty providers and highly skilled technical roles, such as physicians. Training specialized healthcare professionals – especially physicians – requires many resources, and educational programs can only grow as quickly as those resources allow.

Graduate medical education, or the residency training required to become a health provider, has been restricted by a federal cap on Medicare-funded residency programs that’s been in place since 1997. The cap poses serious financial limitations for medical schools to provide clinical training sites, pay for faculty and run operations. As a result, admissions must tighten acceptance, turning away qualified applicants.

The key to unlocking the restriction lies in adjusting funding to meet the current needs of medical schools, and what’s more, allowing localized control of the funding. While workforce shortages are often discussed as a single issue, healthcare staffing challenges vary by profession, geography and community need. More funding is beneficial, but if an area needs more slots for cardiologists, allocating funding for other specialties dulls the impact of that financial support. Increased funding needs to come with increased oversight of utilizing the funds.

Why Workforce Investment Matters

A strong healthcare workforce benefits more than hospital operations.

Healthcare is one of Texas’ largest employment sectors. They provide nearly half a million jobs – accounting for about one in every 12 jobs in Texas and each supporting 2.6 more jobs in other sectors – and contributing to over $104 billion in economic activity each year. Expanding healthcare education does more than fill vacancies. Every residency slot, clinical training site, faculty position and apprenticeship opportunity creates high-wage jobs, supports local economies and helps communities retain talent.

And, healthcare professionals are often among the most trusted members of a community. Their presence helps strengthen relationships between hospitals and the people they serve, improving continuity of care and community health outcomes.

“The healthcare workforce is a community asset, not just a hospital asset,” Williams says. “When we invest in healthcare workers, we’re investing in access to care, economic opportunity and healthier communities.”

Looking Ahead

There is no single solution to the healthcare workforce shortage, but one principle remains clear: investing in people is investing in Texas’ future. Strengthening the healthcare workforce requires sustained attention to education, training, recruitment and retention.

Texas’ reputation is based on extraordinary achievements and setting the tone for the rest of the nation. Texas hospitals are no different. Whether it’s providing state-of-the-art quality care, lifting vulnerable populations through charity care or employing cutting edge technology to restore health, Texas hospitals are leaders in healthcare nationwide.

When it comes to the workforce, Texas hospitals are up to the challenge. Sufficiently staffed hospitals bring down costs for care, lift the load and spirits of the workforce and communities have access to quality care. And hospitals’ unique position as a healthcare provider, a major employer, an economic engine, a public health partner and keystone of any community means that when hospitals and healthcare perform well, so does the rest of the economy.

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