...since an operator doesn’t get paid unless the helicopter carries a patient, there’s an incentive to fly the mission regardless of how adverse the conditions.
There's no incentive in that equation for me to ever accept a flight. Eleven years, I've never had that decision questioned.
Take this to the bank, too: Crashes kill pilots, and in 43 years I've buried a fair few comrades. Kinda focuses my attention each and every time.
And because operators are paid the same rate no matter what equipment they use, operators tend to use older helicopters, and to run them as inexpensively and as ill-equipped as possible.
Ah yes, that nasty profit motive... You either believe in fairies or you don't.
More on "Golden Hour" and Other Myths from the EMS Helicopter Industry explains:
The industry has oversold the need for EMS helicopters. The benefits simply do not outweigh the risks.
I'm not competent to discuss 'the need for EMS helicopters' or the 'Golden Hour", I'm just a pilot. I would guess that the on-scene medical professionals directly responsible for the call and the insurance companies and government agencies that bear the costs of EMS have a better perspective. And, more objective than the source cited by "Shell Management".