Norwegian healthcare norms reshape seven migrant professionals’ views of medical overuse

Medical overuse became recognizable to seven migrant health professionals in Norway only after they were introduced to the concept and reflected on their previous professional experience. In this small qualitative study, participants came to understand overuse as healthcare in which potential harm outweighs benefit. They associated it mainly with structural conditions in their home healthcare systems, including financial incentives, privatization, weak regulation and expectations of treatment.

After encountering Norwegian healthcare, however, most experienced tension between their earlier expectations of care and features they interpreted as possible underuse. The researchers studied seven highly educated migrants with healthcare backgrounds in Bergen, Norway. Participants were recruited through the Integration for Health, or I4H, intervention programme.

The sequential qualitative design combined facilitated group sessions with semi-structured individual interviews. The group sessions introduced medical overuse and established a shared conceptual foundation for the later interviews, which explored how participants interpreted the concept in relation to their professional histories. This approach allowed the researchers to examine both collective reflections and individual accounts of adapting to a different healthcare system.

The individual interviews were audio-recorded, transcribed verbatim and analysed with inductive thematic analysis following Braun and Clarke’s framework. Three themes emerged. First, participants attributed overuse in their home healthcare systems primarily to structural factors rather than to a single type of clinical decision.

Second, most participants described tension between prior expectations of care and their encounters with Norway’s healthcare system. Third, their accounts showed professional recalibration through normative friction: established understandings of appropriate care were re-evaluated against Norwegian approaches emphasizing restraint and resource stewardship. Medical overuse was unfamiliar to all seven participants before the study.

It became recognizable when they connected the idea with their prior professional experience, including extensive testing and intervention. In their home systems, financial incentives, privatization, limited regulation and social expectations surrounding treatment helped shape what they regarded as appropriate care. The findings do not establish that every participant rejected active intervention or that these structural conditions alone caused overuse.

Instead, they show that participants regarded overuse as a legitimate concern arising partly from the organization and incentives of healthcare systems. Most participants had carried expectations shaped by other clinical environments, and several continued to associate extensive testing and intervention with clinical competence. Norway’s gatekeeping, diagnostic restraint and waiting times sometimes prompted them to interpret limited access to testing or treatment as underuse.

They were therefore re-evaluating familiar professional norms without fully abandoning them. Recalibration, as the analysis describes it, was a process of negotiation between previous ideas of appropriate care and the restraint and resource stewardship emphasized in the Norwegian system. The study offers qualitative evidence rather than estimates of how much overuse occurs.

It does not measure service use, compare patient outcomes or determine whether the participants’ interpretations represent those of migrant health professionals elsewhere or of Norway’s wider health workforce. Its findings are based on seven people recruited through one intervention programme in a single city, and the facilitated sessions deliberately introduced the concept before the interviews. The small, locally bounded sample therefore limits generalization.

The results nevertheless document how migration and professional transition can alter the meaning assigned to overuse, restraint and appropriate care. The authors conclude that addressing overuse in diverse healthcare systems should extend beyond guideline dissemination to include explicit engagement with differing professional norms and support for professional adaptation.

Subject of Research: How seven migrant health professionals interpreted medical overuse while adapting to the Norwegian healthcare system

Article Title: Perceptions of medical overuse among health professionals with migrant backgrounds in Norway: a qualitative study

Article References: Haugland-Pruitt, J., Hjörleifsson, S., & Diaz, E. (2026). Perceptions of medical overuse among health professionals with migrant backgrounds in Norway: a qualitative study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15600-0

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15600-0

Keywords: medical overuse, migrant health professionals, Norway, healthcare quality, diagnostic restraint, healthcare gatekeeping, professional adaptation, qualitative research, Perceptions, medical, overuse, health