Context: Illness scripts are networks of knowledge organised for clinical action that clinicians mobilise to carry out their diagnostic and management tasks. Based on the biomedical knowledge that students learn during their first years of training, these illness scripts develop gradually and are continually reorganised as clinicians are confronted with new situations. The COVID-19 pandemic disrupted this logic of construction and progressive encapsulation of knowledge; unexpectedly, clinicians had to deal with a complex, dangerous and atypical disease for which they had no clear, structured clinical script based on existing knowledge.

Aim: This research is part of a wider research plan looking at the construction of the COVID-19 clinical script in different clinical contexts. In this study, we aimed to understand how the COVID-19 illness script was developed by family doctors in the outpatient setting.

Methods: Participants were Swiss outpatient family doctors. We conducted a qualitative study, using the focus group method.

Results: The COVID-19 script was built directly from contact with patients and their various clinical presentations of the disease, in a context of great uncertainty, and from knowledge drawn from different sources, including non-medical sources, which were often contradictory and constantly being updated. Two major themes emerged from the qualitative analysis of our data: 1) differences in the stages of script development with facilitating or constraining factors 2) the crisis as an opportunity for change.

Conclusion: Our results confirm the unusual process of constructing the script for this disease; We were able to identify three phases in the construction of the script: first a phase of confusion, a construction phase, more precisely made up of disorganisation and reorganisation, and finally a consolidation phase. While it is possible to observe a consolidation of the script, it is still incomplete to date, particularly, for example, with regard to the long COVID, its manifestations and its management. This more chronic presentation of the disease is challenging the ways in which professionals collaborate and interact. Further research is needed to address these challenges.