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Purpose  This article analyzes the cognitive microfoundations, conflicting institutional logics and professional hybridization in a case characterized by conflict.    Design/methodology/approach  In contrast to the majority of earlier studies focusing on special health care, the study was conducted in a Finnish basic health care organization. The empirical data include 36 interviews, accounting reports, budgets, newspaper articles and meeting notes collected 2013–2018.    Findings  The use of accounting techniques in this case did not offer professionals sufficient support under conditions of conflict. The authors suggest that this perceived lack of support intensified the negative emotions toward accounting techniques. These negative emotions aggregated into incompatible professional-level institutional logics, which contributed to the lack of hybridization between such logics. The authors highlight the importance of the cognitive microfoundations, that is, the individual-level interpretations and emotional responses, in the analysis of conflicting institutional logics.    Practical implications  Managerial attention needs to be directed to accounting practices perceived as frustrating or threatening, a perception that can prevent the use of accounting techniques in the creation of professional hybrids. The Finnish basic health care context involves inconsistent political decision-making, multiple tasks, three institutional logics and individual interpretations and emotions in various decision-making situations.    Originality/value  This study develops microfoundational accounting research by illustrating how individual-level cognitive microfoundations such as dissatisfaction with budgeting, aggregate into professional-level institutional logics, and in our case, prevent professional hybridization in a basic health care setting characterized by conflict and three separate institutional logics.

Accounting, microfoundations, hybridization and longitudinal conflict in a Finnish health care organization