In this increasingly tech-savvy age, it has become common to “google” one’s symptoms. For many of us, consulting the virtual Dr Google has become the first port of call for medical information. A recent Australian study by the  Queensland University of Technology titled ‘'Dr. Google' doesn't know best: Search engine self-diagnosis and 'cyberchondria'', has shown that 5% of all monthly Google searches are now health related; this equates to approximately five billion monthly searches.

But what are the risks of looking up (sometimes unchecked) information available on the web? Is Dr Google more of a foe than a friend?

I used Google to examine the information available online on Cauda Equina Syndrome (CES). This serious condition affects the nerves in the lumbar spine. It can cause permanent damage to bowel and bladder functions, numbness in the saddle area and potentially paralysis and mobility problems if the nerves are permanently damaged. On the onset of symptoms, there is generally a short timescale for the completion of successful decompression spinal surgery.

I started by googling the very broad terms “back pain”. According to Google, one in three adults in the UK experiences back pain at some point. Aside from the advertising banners for muscle relaxant creams, the first webpage to come up is that of the NHS which provides some general information and states that back pain is “not generally caused by a serious condition”. It provides condensed information about the types of back pain, what to do, treatment and signs of a serious problem. However, it does not specifically mention CES, perhaps because this is a rare condition and because the causes of back pain are so varied.

The next article is from a patient group and provides comprehensive information with useful diagrams. The article is detailed and does mention CES and stresses the urgency of seeing a medical practitioner. It also provides some crucial information about the key symptoms of CES.

Further down the page of search results is a general Wikipedia entry about back pain, followed by a news article about a man who has been caught growing a significant amount of cannabis in Wales used to ease his back pain. What this goes to show is that the information that Dr Google offers is broad and diverse. It simply cannot be tailored to one’s specific concerns hence why it should be approached with caution if used to self- diagnose. It can create a false sense of security or conversely “cyberchondria”.

The recent study has found that people who consult Dr Google to self-diagnose often end up with misleading or incorrect information. Hence, whilst one may gain a sound understanding of the anatomy of the back, Dr Google might miss significant medical issues and should not detract from consulting “real life” medical practitioners.

In the recent landmark ruling of Montgomery v Lanarkshire Health Board  [2015] UKSC 11, the Supreme Court has made it clear that medical practitioners have the onus of obtaining informed consent from patients prior to offering treatment. There is a shift towards patient focus and individual empowerment and it is clear that doctors must take reasonable care to ensure that a patient is aware of any material risks involved in a proposed treatment and advise of reasonable alternatives. The materiality of a risk has not been quantified by the Supreme Court. It was held that a risk is deemed to be material if a reasonable person in the patient's position would be likely to attach significance to it, or if the practitioner is or should reasonably be aware that the patient would be likely to attach significance to it.

Dr Google can be a powerful tool in the landscape of patient empowerment. Studies have demonstrated that patients who use recommended medical websites significantly improve their knowledge about their treatment and report increased satisfaction with the consent process whilst not experiencing increased anxiety levels. Given the requirement for obtaining informed consent, doctors may be tempted to refer their patient to online material to ensure that they are aware of all the risks associated with a particular procedure. Whilst this virtual information may equip patients with valuable knowledge, it should not replace face-to-face discussions with doctors and is no substitute for good bedside manner.

Dr Google is both a friend and a foe, depending on how it is used. It is a foe if you use vague search terms but if you check the veracity of your sources, use it wisely, and in conjunction with the advice received from a real life medical practitioner, it can provide a wealth of useful information.