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

Abstract Background Medical overuse, defined as the provision of healthcare where potential harm outweighs benefit, is a growing global concern that often coexists with underuse. Migrant health professionals bring experience from healthcare systems shaped by different clinical norms, resource constraints, and understandings of appropriate care. However, little is known about how they interpret concepts such as medical overuse when adapting to the Norwegian healthcare system. This study aimed to explore how migrant health professionals in Norway understand and interpret medical overuse in a new healthcare context. Methods A qualitative study was conducted in Bergen, Norway, using a sequential design combining facilitated group sessions and semi-structured individual interviews. Participants ( n = 7) were highly educated migrants with healthcare backgrounds recruited through the Integration for Health (I4H) intervention programme. Facilitated group sessions introduced the concept of medical overuse and provided a shared conceptual foundation for subsequent interviews. Individual interviews were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis following Braun and Clarke’s framework. Results Medical overuse was unfamiliar to all participants before participation in the study but became recognizable through reflection on prior professional experience. Three themes were identified. First, participants attributed overuse in their home healthcare systems primarily to structural factors, including financial incentives, privatization, weak regulation, and expectations of treatment. Second, most participants experienced tension between prior expectations of care and encounters with the Norwegian healthcare system, often interpreting gatekeeping, diagnostic restraint, and waiting times as indicators of underuse. Third, participants described a process of professional recalibration marked by normative friction between established understandings of appropriate care and Norwegian approaches emphasizing restraint and resource stewardship. Several participants continued to associate extensive testing and intervention with clinical competence despite acknowledging overuse as a legitimate concern. Conclusion Understandings of medical overuse are shaped by professional norms developed within specific healthcare systems and re-evaluated through experiences of migration and professional transition. Differences in healthcare-system structures and expectations of appropriate care may generate normative friction when health professionals encounter new clinical cultures. Efforts to address medical overuse in increasingly diverse healthcare systems should extend beyond guideline dissemination to include explicit engagement with differing professional norms and support for professional adaptation.