This qualitative study explores the views of 12 genetic counselors (GCs) in Australia working in new genomic care models across five specialties. Guided by Diffusion of Innovation Theory, interviews revealed varied interpretations of "genomics mainstreaming." Some GCs viewed it as specialists independently practicing genomics, while others emphasized GCs' crucial role. GCs saw their role in expediting patient access and enhancing specialist capabilities. Challenges included specialist hesitancy towards genomics, tensions between genetic and non-genetic professionals, and concerns about care standards when non-genetic colleagues manage consent and disclosure. Leadership support and peer connection were identified as essential for GCs' success in mainstream settings.
