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Introduction Airway disease is common, yet under- and misdiagnosis remain challenging. Diagnostic pathways rely heavily on spirometry, which despite being widely accepted as the ‘gold standard’ test, has recognised limitations. This qualitative study explores how respiratory physiologists and respiratory physicians perceive oscillometry and other emerging technologies, identifies barriers and facilitators to implementation, and explores how clinical pathways could be optimised for earlier and more accurate diagnosis of airway disease.Methods This ongoing study involves semi-structured interviews, conducted and recorded via videoconference by MG. Questions focus on clinicians’ understanding and experiences of oscillometry and novel technologies, their perceived value, barriers and facilitators, and views on optimal diagnostic pathways. Clinicians working at ≥ Band 7 and responsible for the referral or performance of lung function tests are eligible and have been purposively recruited. Completed interviews were transcribed verbatim, and anonymised transcripts will be coded and analysed thematically.Results Eight participants have been interviewed to date: three lead respiratory physiologists, three clinical scientists, and two respiratory consultant physicians, with four further interviews scheduled. Early insights show emerging patterns in test familiarity, trust, and perceived clinical value. Key facilitators to implementation include: 1) a clear understanding of oscillometry’s clinical role, interpretation, and service and financial benefits; 2) evidence of validity and reliability in routine clinical practice rather than research settings alone; and 3) training, guidance, and endorsement from professional bodies such as ARTP, BTS, and NICE. Additional insights relate to misdiagnosis, long waiting times, and unnecessary testing. Suggested improvements to diagnostics pathways include: 1) a robust triage system supported by accessible screening tools; 2) objective tests deliverable in primary care or community settings requiring minimal technical expertise and supporting a thorough clinical history taking; and 3) reserving secondary care for more complex cases requiring specialist assessment.Conclusions Respiratory physiologists and respiratory consultant physicians emphasise the need to improve understanding and awareness of oscillometry, supported by training, guidance, and endorsement from professional bodies. Additionally, the value of sharing service-level evaluation data demonstrating oscillometry’s role in real-world clinical practice. These insights will help optimise pathways aimed at achieving earlier and more accurate diagnosis of airway disease.