No Margin, No Mission? How Emergency Medical Service Crews Attend to Competing Financial and Social Goals on 9-1-1 Calls
Strategic Management Journal 46(13): 3118–3151
Frontline professionals shift priorities as financial pressure and patient needs change.
Summary & citation
Research summary
Using quasi-random assignment of patients to EMS crews across 31 U.S. states, we examine how professionals attend to interdependent financial and social goals within the same task. Crews prioritize the financial goal on privately insured calls, but shift toward the social goal when agency financial need is lower or call acuity is higher. These patterns are particularly pronounced in nonprofit agencies.
Why it matters
An organization’s formal mission does not fully determine what employees prioritize. The study suggests that how professionals understand immediate risks to financial viability and patient care can shape their decisions, even without direct financial incentives.
About the visual
An original conceptual illustration of the paper’s findings. The arrows indicate shifting priorities, not a quantified effect or a zero-sum allocation of care. Financial priorities are more evident on privately insured calls; lower agency financial need and higher patient acuity shift attention toward social goals. Read the source in the paper ↗