Private practice dentists' conceptions of overtreatment: A qualitative study from Norway.

Abstract

Objective: As overtreatment has gained attention and is a threat to sustainable healthcare, the objective of this study is to investigate Norwegian private practice dentists' conceptions of overtreatment.  Material and Methods: Six private practice dentists were interviewed. Interviews were transcribed verbatim and analyzed by thematic analysis in a six-step process including coding and identifying main- and sub-themes.

Results: The main themes identified were conceptions of overtreatment, internal factors, and external conditions of importance for overtreatment. Norwegian private practice dentists are familiar with the concept overtreatment and provide several examples of overtreatment. Although they see overtreatment as a problem, they express that the boundaries of what is considered necessary or professionally justified treatment have changed over time - particularly towards aesthetic and cosmetic treatment. Overtreatment is considered to be less problematic if the patients are informed and consent. The participants point to several internal factors and external conditions furthering overtreatment: professional status and prestige, general social trends, social media, demographic changes, overcapacity, and the expansion of commercial chains. The dentists in the interviews demonstrated that they are aware of their power, but also acknowledge their responsibility.  Conclusion: Private practice dentists in Norway are aware of overtreatment and their drivers. They acknowledge their power to promote overtreatment, but also that this gives them responsibility. This raises important issues about dentists' professional accountability and integrity.