Building on earlier conceptualizations of Scandinavian-type care pathways for neurodevelopmental disorders as Ostromian common pool resources (CPR:s), this presentation uses the Price equation from (cultural) evolution science to model the observed CPR dynamics quantitatively. The Price equation applies because professional fitness in an organization co-varies differently with different professional strategies. Along with in-group processes, the model parsimoniously explains spread or non-spread of professional behavior serving different functions. Importantly, how professional behavior co-varies with professional fitness depends both on organizational context and organizational level. To exemplify, budget-keeping behavior may be more associated with professional pay-off than doing high-quality work. Professionals interested in high-quality work rather than budget keeping may then discount future profits and exit the care pathway, further strengthening transmission and replication of budget-keeping behavior. When applied to inter-professional cooperative behavior, the Price equation also clarifies that care pathways of the type studied are sub-optimally structured to elicit appropriate professional cooperation. Seeing the relevance of evolutionary dynamics in everyday health care structures helps to influence and predict professional activity in these systems.