Businesses and families are flocking to Texas, adding nearly 400,000 new residents in 2025. To keep our great state healthy, we need a healthcare system that can keep up. Texas needs to add roughly 2,100 to 2,700 healthcare workers monthly just to keep up with population growth. The stakes are clear: When there aren’t enough people to provide care, patients wait longer, travel farther and too often go without.
Retention and growth require multiple solutions – a combination of internal advancement opportunities, creative pathways into the profession and financial incentives.
As the largest segment of the hospital workforce, nurses are central to quality, safety and operational stability. Persistent nursing shortages pose significant challenges to timely and effective care for patients across the state. Texas hospitals have taken that challenge seriously.
For example, the Shared Nursing Academic Practice Partnership Initiative (SNAPPI) expands the clinical education pipeline by identifying current RNs to teach students on or near their usual units, while keeping their primary clinical roles. Hospitals invest in pay and schedules that integrate teaching into their job – not add on top of it. First piloted at Sam Houston State University, SNAPPI promotes flexibility to adapt where workforce constraints are most severe.
When hospitals invest in their workforce, they curate the future workforce and directly support their community. Students and healthcare professionals who train locally are more likely to stay and practice in the region, bring specialized skills, stable incomes and long-term economic activity with them.
Nursing shortages have long strained the system, but that’s not the whole picture. Mounting shortages among technicians – radiology, imaging, clinical, laboratory, surgical – now demand equal attention. These roles are vital to delivering quality, timely patient care. But, people to fill these roles are scarce in certain pockets of the state.
Apprenticeships and earn-while-you-learn programs help address the pipeline by upskilling workers and filling vacancies simultaneously, while easing the economic barriers that push people out before they get started. Providing opportunities to grow within the healthcare system – often known as “growing your own” – compounds that investment. Clear lines of progression and promotion help hospitals stay ahead of shortages rather than simply react to them.
The healthcare field has an abundance of growth opportunities, and this upward mobility of the workforce keeps the system strong and care available. Every new faculty position, residency slot or clinical training site is both an employment opportunity and a retention strategy.
Across specialties, a common thread is clear: Barriers to entering and staying in healthcare are financial as well as structural.
Attracting new graduates to the field requires more than encouragement; it requires removing financial barriers. Expanding loan repayment programs that incentivize applicants to serve in high-need or hard to recruit fields with built-in forgiveness is a concrete, proven way to do that.
A recent federal Department of Education (ED) rule moves in the opposite direction. Effective July 1, it excludes several highly skilled health professionals such as advanced practice nurses, physician assistants, occupational and physical therapists and social workers from their definition of “professional student.” As a result, these professions have a lower loan cap than other ED-deemed “professional” degrees, reducing the ability to fund a healthcare education. For healthcare professionals pursuing advanced degrees, that gap is not abstract – it is a career decision. Barriers like this directly undermine efforts to expand and sustain the workforce, including limiting the faculty pool that Texas needs.
As workforce pressures mount, Texas is not standing still. The state reinforces its commitment to workforce stability through its nurse staffing law (Texas Health & Safety Code Chapter 257), which requires hospitals to establish nurse staffing committees. These committees give nurses a formal, ongoing voice in staffing plans, resource allocation and practice conditions – letting clinicians help shape the environments where they work, from bedside to boardroom. When clinicians can meaningfully influence their working conditions, retention follows.
Texas’s healthcare workforce is robust and vital to ensuring Texans receive the highest quality of care. We must continue to invest in our technicians, physicians, nurses and every member of the healthcare community. Investing in the healthcare workforce is an investment in patient care, the state’s economy, the stability of local communities, our emergency response capabilities and the promise that every Texan can build a successful, rewarding and meaningful career.
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