PRESS RELEASE: Is the Royal Australian College of GPs harming patients?

MEDIA RELEASE
11 March 2026

Is the Royal Australian College of GPs harming patients?

An article in the Australian Journal of General Practice criticises the Royal Australian College of GPs (RACGP) for recommending a therapy that harms up to 75% of patients. Peak patient body Emerge reports that some patients experience irreparable harm.

In a dismissive response, the RACGP discounted multiple research studies reporting harm as “bias”. Patient groups have reacted with anger and outrage. “I’ve read that in clinical practice, ‘the care of your patient is meant to be your primary concern’. But that’s not what I see here. The RACGP seems more concerned about justifying themselves than in adapting to provide better care. In continuing to promote graded exercise therapy, they are harming people with ME/CFS like me,” said Sarah from Canberra.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe neurological disorder that compromises the ability of 500,000 Australians to work, enjoy leisure activities or perform self care. The disease affects almost 2% of Australians, making it as common as cancer, according to the Australian Bureau of Statistics. ME/CFS disproportionately affects women.

Half of long COVID sufferers have ME/CFS, which is usually contracted after an infection.

The RACGP believes that ME/CFS can be cured with graded exercise therapy. Graded exercise therapy supporters assert that ME/CFS is simple deconditioning, caused by a psychological fear of exercise. But recent discoveries of numerous genetic, metabolic, mitochondrial, circulatory, immunological, neurological, cellular and structural abnormalities in ME/CFS patients make mockery of that belief. It appears that ME/CFS patients have been gaslighted.

The defining feature of ME/CFS is post-exertional symptom exacerbation – an exertion intolerance that causes prolonged symptom flares lasting days, weeks, months or even years. Flares cause incapacitating cognitive problems, increased pain, and gut, sleep, immunological and neurological disturbances. They can be brought on by physical exercise, as well as cognitive, social or emotional exertion. Yet, nonsensically, the RACGP recommends graded exercise therapy for ME/CFS. Graded exercise therapy is contraindicated in the US and the UK. It’s time for the RACGP to follow suit.

Contact information:
Jackie Stallard
[email protected]
0447 698 874

Patient who has been harmed by graded exercise therapy:
Andrew Bretherton
[email protected]
0415975052

Patients who are willing to be interviewed:
Jackie Stallard
[email protected]
0447 698 874

Ronja Schubert
[email protected]
0490 100 830

ME/CFS Experts:
Assoc Prof Bernard Shiu (medical doctor, Chair of the RACGP Energy Limiting and Post-Infection Conditions (ELPIC) Special Interest Group)
[email protected]
03 5248 1299

Prof David Putrino (2019 Advance Australia Award winner, Researcher at the Icahn School of Medicine at Mount Sinai in New York City. Emerge Ambassador.)
[email protected]

National Patient Organisation Emerge:
Anne Wilson (CEO)
[email protected]
0400 165 391

Politicians who have spoken out about the problems with graded exercise therapy in ME/CFS:
Senator Jordon Steele-John
[email protected]
Principal office (08) 6245 3310
Parliament office (02) 6277 3646

Sources:
Article criticising the RACGP’s treatment of ME/CFS – https://www1.racgp.org.au/ajgp/2026/march/is-the-racgp-handi-recommendation-of-incremental-p
RACGP’s response – https://www1.racgp.org.au/ajgp/2026/march/invited-response-to-viewpoint-article

RACGP recommends graded exercise therapy for ME/CFS – https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/exercise/incremental-physical-activity-for-cfs-me

ME/CFS prevalence – https://mecfs.org.au/about-the-condition/what-is-me-cfs

Cancer rates – https://www.abs.gov.au/statistics/health/health-conditions-and-risks/health-conditions-prevalence/latest-release#:~:text=Mental%20and%20behavioural%20conditions%20%E2%80%93%2026.1,and%20behavioural%20conditions%20%E2%80%93%2051.8%25.

Emerge – graded exercise therapy can causes irreparable damage – https://emerge.org.au/exercise-as-treatment-for-me-cfs-and-long-covid/

Financial costs of ME/CFS – Close S., Marshall-Gradisnik S., Byrnes J., Smith P., Nghiem S., & Staines Don (2020). The Economic Impacts of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in an Australian Cohort, Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.00420

Paper showing that 54-74% of people with ME/CFS worsen after graded exercise therapy – Geraghty, K., Hann, M., & Kurtev, S. (2019). Myalgic encephalomyelitis/chronic fatigue syndrome patients’ reports of symptom changes following cognitive behavioural therapy, graded exercise therapy and pacing treatments: Analysis of a primary survey compared with secondary surveys. Journal of Health Psychology, 24(10):1318-1333. doi:10.1177/1359105317726152

Paper showing that 83% of people with ME/CFS worsen after graded exercise therapy – Eckey, M., Li, P., Morrison, B., Bergquist, J., Davis, R.W., & Xiao, W. (2025). Patient-reported treatment outcomes in ME/CFS and long COVID: Dataset 1. Proc. Natl. Acad. Sci. U.S.A. 122(28) e2426874122, https://doi.org/10.1073/pnas.2426874122

Review paper showing genetic disposition and evidence of physiological abnormalities – Arron HE, Marsh BD, Kell DB, Khan MA, Jaeger BR and Pretorius E (2024) Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: The biology of a neglected disease. Front. Immunol. 15:1386607. doi: 10.3389/fimmu.2024.1386607

International diagnostic criteria for ME/CFS – Carruthers, B. M., van de Sande, M. I., De Meirleir, K. L., Klimas, N. G., Broderick, G., Mitchell, T., Staines, D., Powles, A. C., Speight, N., Vallings, R., Bateman, L., Baumgarten-Austrheim, B., Bell, D. S., Carlo-Stella, N., Chia, J., Darragh, A., Jo, D., Lewis, D., Light, A. R., Marshall-Gradisnik, S., … Stevens, S. (2011). Myalgic encephalomyelitis: International Consensus Criteria. Journal of Internal Medicine, 270(4), 327–338. https://doi.org/10.1111/j.1365-2796.2011.02428.x

Post-exertional symptom exacerbation characteristics – Mateo, L. J., Chu, L., Stevens, S., Stevens, J., Snell, C. R., Davenport, T., & VanNess, J. M. (2020). Post-exertional symptoms distinguish myalgic encephalomyelitis/chronic fatigue syndrome subjects from healthy controls. Work, 66(2), 265–275. https://doi.org/10.3233/WOR-203168

UK contraindicates graded exercise therapy – National Institute for Health and Care Excellence (2021). Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: Diagnosis and management. Royal College of Physicians Guidelines, downloaded from https://www.nice.org.uk/guidance/ng206, accessed 22 October, 2022 and Baraniuk J. N., Marshall-Gradisnik, S., & Eaton-Fitch, N. (2024). Myalgic encephalomyelitis (Chronic fatigue syndrome): Straight to the point of care. BMJ Best Practice, downloaded from https://bestpractice.bmj.com/topics/en-gb/277, accessed 4 March, 2025.

US contraindicates graded exercise therapy – 11. Centers for Disease Control (2025). Strategies to Prevent Worsening of Symptoms, downloaded from https://www.cdc.gov/me-cfs/hcp/clinical-care/treating-the-most-disruptive-symptoms-first-and-preventing-worsening-of-symptoms.html, accessed 23 February, 2025.