Medicine OP


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Deadmanwalking wrote:

Damage was meaningless outside combat past very low levels in PF1 just due to Wands of CLW.

At least this version of being healed between each encounter takes significant time, and as levels rise significant character investment.

I was always hoping Paizo would fix the pricing on cure wands or make an adjustment to wands functions. I was not wanting a whole new system.

New with medicine it is the same issue but characters are "hiding" for hours to cure up after combat. It fixed nothing just changed the problem. IMO

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Pathfinder Adventure Path, Lost Omens, Maps, Rulebook Subscriber
MaxAstro wrote:
rainzax wrote:
John Lynch 106 wrote:
I'm using a tension pool system (from this website) which means a complication occurs effectively every hour.
Thanks for this.
Let me add thanks, too. This is an amazing idea and I'm totally going to use it from now on in place of normal random encounter rolls. Should be easy to work into 2e, too, since so many things take ten minutes...

I will add to the chorus saying thanks for this. I will definitely be using this in my home games from now on.

There are bits of 2e that seem to accommodate a Powered by the Apocalypse style of narrative game play and this would add a lot to it.


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Pathfinder Lost Omens, Rulebook Subscriber

Will be trying tension tonight most likely.


Cylerist wrote:
Deadmanwalking wrote:

Damage was meaningless outside combat past very low levels in PF1 just due to Wands of CLW.

At least this version of being healed between each encounter takes significant time, and as levels rise significant character investment.

I was always hoping Paizo would fix the pricing on cure wands or make an adjustment to wands functions. I was not wanting a whole new system.

New with medicine it is the same issue but characters are "hiding" for hours to cure up after combat. It fixed nothing just changed the problem. IMO

I mean I suppose it depends what sort of games you play in, but as a non-module player I don't really consider that a problem. In my games I don't really have a fixed plot so tend to change what things happen based on what time it is and what has previously happened, by a lot. At least for my group "do we heal up or do we solve the current problem now" is a pretty reasonable trade-off to have available.

Personally my main issue with wand based healing is the thematics. I'd rather run a game where medical attention, even implausibly good medical attention, is the primary way of fixing people up, over a game where you primarily pay money for healing.


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Actually, on that note, how is it that spending time recieving healing, triage, and recuperation is viewed as videogamey but an in-world "insert quarters to restore health" isn't? That's just freaking Gauntlet! XD


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Pathfinder Adventure, Adventure Path, Lost Omens, Pathfinder Accessories Subscriber

I think by tracking the time it takes is what balances it considering a failure means have to try again in another hour. If it takes hours to heal that is a lot of time in the dungeon to be doing nothing. If you just handwave it to say you are all healed, then you have lost that balance of time to heal.

The problem in 'fixing' the heal to full is the devs balanced the game with a variable length short rest assumed after each encounter. That means the monsters are designed to start the encounter knowing they can damage you from full, rather than pulling their punches (doing less damage) to account for players having already suffered damage. If you remove the after encounter healing as not being realistic - then you are going to be behind on the math curve and falling sooner needing even more healing! If anyone suffered wounds and did not take care of it between encounters, they are more likely to die when they fall.


I have house-ruled that Medicine / First Aid only applies once per encounter per individual.

Basically it reflects how much healing someone can tend to after a fight. Bandage / stitch wounds; savle sore muscles, etc...

Any damage left over needs time or magic to heal.


orphias wrote:

I have house-ruled that Medicine / First Aid only applies once per encounter per individual.

Basically it reflects how much healing someone can tend to after a fight. Bandage / stitch wounds; savle sore muscles, etc...

Any damage left over needs time or magic to heal.

Your house rule is actually stronger than the RAW. Battle Medicine only works once per day per person, and Treat Wounds only works once every ten minutes (assuming you have Continual Recovery).


Personally I think one use of treat wounds per encounter is fine.

Don't see how that is more powerful than RAW when Treat Wounds can be used continuously every hour or 10 minutes with the "recovery" until fully healed.


Pathfinder Lost Omens, Rulebook Subscriber

I think if you did that you should also add a Long Term care skill use to reflect the continual tending to wounds that happens over long periods. Perhaps only usable once per day and it doubles (triples at Master, quads at Legendary) their normal natural healing from rest.


orphias wrote:

Personally I think one use of treat wounds per encounter is fine.

Don't see how that is more powerful than RAW when Treat Wounds can be used continuously every hour or 10 minutes with the "recovery" until fully healed.

he misunderstood your house rule. He thought you were allowing additional uses of the battle medicine feat.

What is the in game justification for people being immune to battle medicine being a daily per power target? Or is it a case of game balance superseding in game reality?


I guess you could think of Battle Medicine as a suped-up steroid / adrenaline hit as it is used in combat and happens really fast. More than once per day and the person risks an Overdose :)


orphias wrote:
I guess you could think of Battle Medicine as a suped-up steroid / adrenaline hit as it is used in combat and happens really fast. More than once per day and the person risks an Overdose :)

That works.


John Lynch 106 wrote:
orphias wrote:
I guess you could think of Battle Medicine as a suped-up steroid / adrenaline hit as it is used in combat and happens really fast. More than once per day and the person risks an Overdose :)
That works.

Just like how you can think of Treat Wounds as herbs, Salves, medicinal techniques, etc. that heal the body and restore energy fairly quickly without an arbitrary once-per-encounter limitation. XP

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Fallyna wrote:
Elaserdar wrote:
Any thought(s) / feelings? / Suggested Nerfs?

Healing may feel almost inconsequential if the party invest skill feats into the skill, so another option may be to look at the Healers Kit from 1st edition.

This collection of bandages and herbs provides a +2 circumstance bonus on Heal checks. A healer’s kit is exhausted after 10 uses. (50 GP)

The bonus is much the same as 2e in terms of effect (+2 then is +1 now), but the previous version had limited uses and a cost in gold to refill. The lack of a use limit in 2e may be a misprint/error? This won't affect how often they can heal, but the cost will limit them financially and hopefully encourage better tactics when infinite free healing isn't available.

You talk about better tactics, but I don't know if that's a fair expectation. The way the new system is set up, it's just about impossible to have so much AC that monsters can't hit you. In fact, boss and mini-boss monsters will hit you a LOT.

Sure, you can reduce the opportunities they get by not running forwards. PF1 did indeed encourage "kill them so fast they don't get to hit us" tactics, and those tactics will probably get you quite dead in PF2. Any monsters above speedbump CR won't die fast enough for that.

But what would good tactics be for avoiding the need to heal? I don't think they exist. You can through reduce the need for healing, but not by enough to not need a robust healing system. Because the game system is set up ("rigged") to ensure you get hit.

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Elaserdar wrote:

This is one of the problems with the skill. The old CLW wand was an expended resource. As was the old healers kit.

Cleric spell slots are also an expended resource.

Maybe Im just butthurt because the "free" healer's kit uses are way more effective than my crappy 1d6 alchemist elixirs :p

The thing with the CLW wand was that it was not a daily resource. You could basically pull weeks' worth of a level 1 cleric casting healing spells and use them in a single day. You could get far more healing out of a wand in a few minutes than a mid-level cleric could do in a single day, even if he's willing to be useless the rest of the day.

And, in PFS, the wand was just too damn cheap. After the first session, each character can afford one. At an average of 5.5 hp healing per charge, that gives a level 1 party of 6 characters a cushion of 1650hp to land on. That doesn't really feel like an "expended resource" anymore.

It also created a big problem for writers. Do we write assuming parties go into each encounter at full health, or not? Some GMs might allow easy wands, some might allow wands but not at the super cheap price of PFS, and some don't allow it. Hard to write stuff that fits all three.

So putting a more standardized expectation of healing into the CRB is great. The new healing resource is Time. If you want to have a series of anxious encounters, you can use somewhat lesser monsters but not give the PCs easy chances for 10-60 minutes rest in between. If the area the PCs are exploring gives good opportunities to hole up and recover, you know that you can throw heavier encounters and that the main attrition the PCs are facing is daily powers, not HP/focus. Or you can play with it a bit and say that there are patrols every 8 minutes and by succeeding at a skill challenge the PCs can hide a single patrol. That creates the "we're trying to catch our breath but it's not easy" tension to the game. All in all, this gives writers a tool to write better balanced encounters.


Ascalaphus wrote:


The thing with the CLW wand was that it was not a daily resource. You could basically pull weeks' worth of a level 1 cleric casting healing spells and use them in a single day. You could get far more healing out of a wand in a few minutes than a mid-level cleric could do in a single day, even if he's willing to be useless the rest of the day.

And, in PFS, the wand was just too damn cheap. After the first session, each character can afford one. At an average of 5.5 hp healing per charge, that gives a level 1 party of 6 characters a cushion of 1650hp to land on. That doesn't really feel like an "expended resource" anymore.

It also created a big problem for writers. Do we write assuming parties go into each encounter at full health, or not? Some GMs might allow easy wands, some might allow wands but not at the super cheap price of PFS, and some don't allow it. Hard to write stuff that fits all three.

In an intense, time-sensitive quest, dungeon or adventure, the medicine skill is nearly useless, and a party without a dedicated magical or alchemical healer is in very big trouble. For example, if your GM ever has the monsters in the next room hear you fighting, prepare for combat and then rush you, you are in big trouble without magical healing.

More than replacing magical healing, I see that magical/alchemical and non-magical healing were given separate strengths and it is much better for a party to have both if possible, without tanking combat effectiveness. Battlefield Medicine is not a trap feat, (it is pretty effective) but it can trick parties into thinking that they have their combat healing needs covered effectively when they really do not. It can cover a little combat healing in a pinch, but your front line is not going to be kept on their feet for long without magical healing. Which is extra-bad, because the first aid action to stabilize dying allies and stop bleeding is far behind the stabilize cantrip in utility or effectiveness - it is an action drain that can get the party overwhelmed really fast when one character drops and a second character has to spend a full round or two to save them. Any Medicine skill function that requires a healer's kit is very difficult to pull off in a single round of combat and will still require that you are comfortable dropping you weapons, and having to try to stay adjacent to your frontline allies as much as possible.

A party with both magic/alchemical healing and nonmagical healing has the ability to do out of combat healing very quickly if necessary without wasting much of their wealth, by using up some of their magical resources, but won't have to do that very often. In PF2 it is much harder to replace an entire character with a bag full of cheap magical healing items, but it is possible (and often a good idea for redundancy sake) to break up the healing responsibilities between characters, just not at the cost of requiring anyone to abandoned their overall combat effectiveness. You just need to be careful as you look at your adventuring team that you don't have two or three characters who think they are going to be able to be the party's primary healers because they have a 14 wisdom, the medicine skill and a battlefield medic, but also carry shields or be a longbow ranger who is going to try to hide out far away from the rest of the party and snipe away with arrows but still be able to save a melee ally who drops to dying 2 with a bad crit.

A second level dip into a divine or primal spell list (it needs the stabilize cantrip) makes for a much better emergency healer than investing in the medicine skill and skill feats to make it useful. Especially because it opens up the use of scrolls and wands for healing options that scale up in level without any additional resource dedication.


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Somebody posted this in a different thread. I thought it might be interesting to add to this conversation.

“It is quite unreasonable to assume that as a character gains levels of ability in his or her class that a corresponding gain in actual ability to sustain physical damage takes place. It is preposterous to state such an assumption, for if we are to assume that a man is killed by a sword thrust which does 4 hit points of damage, we must similarly assume that a hero could, on the average, withstand five such thrusts before being slain! Why then the increase in hit points? Because these reflect both the actual physical ability of the character to withstand damage – as indicated by constitution bonuses- and a commensurate increase in such areas as skill in combat and similar life-or-death situations, the “sixth sense” which warns the individual of some otherwise unforeseen events, sheer luck, and the fantastic provisions of magical protections and/or divine protection.”

-Gary Gygax, D&D 1st edition DM's guide


Unicore wrote:
In an intense, time-sensitive quest, dungeon or adventure, the medicine skill is nearly useless, and a party without a dedicated magical or alchemical healer is in very big trouble. For example, if your GM ever has the monsters in the next room hear you fighting, prepare for combat and then rush you, you are in big trouble without magical healing.

A good GM would probably consider those two encounters to effectively be the same fight and consider that when they set the XP budgets for each room.

Unicore wrote:
but your front line is not going to be kept on their feet for long without magical healing.

Fortunately that's a choice GMs get to make. In PF1e there was no non-magical option for healing. PF2e provides GMs with tools (time and non-magical healing) that are much more easily used to dictate the style of game they're running.

A GM can decide to run their players through a gauntlet that is unsurvivable without someone preparing heals in a good portion of their spell slots (i.e. the iconic healbot). Or a GM can choose not to run their game in such a manner.

Hopefully a GM would warn players of the style of campaign they're organising so that the players can plan accordingly.


Edge93 wrote:
Actually, on that note, how is it that spending time recieving healing, triage, and recuperation is viewed as videogamey but an in-world "insert quarters to restore health" isn't? That's just freaking Gauntlet! XD

That's what puzzles me. We finally get a skill that if heavily invested into, can make anyone a viable party healer and supporter, and the fact this takes time and you have to be safe for the duration is somehow compared to elixirs and wands which can be used mid-combat. I know BattleMedic is a thing but that thing adds an extensive immunity period, and can be a risky gamble since you can't heal after combat.

This skill reminds me of Darkest Dungeon, where the party actually settles down to rest. The survivalists can forage some food, craftsmen can repair gear and medics can patch the party up as the casters refocus. Isn't this the best case scenario for immersive adventuring?


John Lynch 106 wrote:
Hopefully a GM would warn players of the style of campaign they're organising so that the players can plan accordingly.

I played (briefly, before moving away) in a campaign where magic was rare (and highly illegal) and that everyone should be prepared for a pretty low-magic campaign.

We found a wand of cure light pretty early, with something like 7 charges. We blew through the whole thing in about an hour game-time. We also had a PC die outright that the GM handwaved some (effectively) divine intervention so that they survived at the time. They then took another lethal hit and the GM Was like, "Yeah you're dead this time, I can't really save you a second time like that."

My friend and I were in pretty solid agreement that the campaign was not going to work out in the long run as the GM wasn't adjusting the difficulty to account for the lack of magic and was more or less running a pre-written adventure with a quarter of the loot and not allowing spellcaster PCs.

The idea was nice, but the execution...didn't work.


Ascalaphus wrote:


You talk about better tactics, but I don't know if that's a fair expectation. The way the new system is set up, it's just about impossible to have so much AC that monsters can't hit you. In fact, boss and mini-boss monsters will hit you a LOT.

Sure, you can reduce the opportunities they get by not running forwards. PF1 did indeed encourage "kill them so fast they don't get to hit us" tactics, and those tactics will probably get you quite dead in PF2. Any monsters above speedbump CR won't die fast enough for that.

But what would good tactics be for avoiding the need to heal? I don't think they exist. You can through reduce the need for healing, but not by enough to not need a robust healing system. Because the game system is set up ("rigged") to ensure you get hit.

I wouldn't go quite this far. While it is true that monsters have really, really good to hit numbers to keep them relevant and threatening, we have a lot more defensive tactics to mitigate damage. Hit and run monks, shield blocks, Champion reactions... even hiding and sneaking seems better for it now. Kobra, the low dex playtest monk used by one of the Paizo staff, is a pretty sterling example of tactics reducing damage.

Which isn't to say you shouldn't have some sort of healing option. I'd even go so far as to say you need it. But at least even that is somewhat open ended. For example, if don't like the flavor of Treat Wounds you can accomplish much the same thing by just having a Champion in your party-- laying on hands every 10 minutes without even needing a roll. Or if your monk wants to stand and trade blows rather than try to avoid being targeted, you can take Wholeness of Body so their own internal healing is covered. Use maneuvers and/or Stand Still to lock down enemies and funnel all that damage to yourself.

But I think both of those examples do support the idea that this game can handle PCs going into most fights at full health. They've built in too many ways to achieve it otherwise.


Myself, I kind of like the idea that medics in-universe are capable of honing their skills to the point that the gap between properly applied medicine and "Hurt-B-Gone" magic is much smaller than it used to be, although the gap is still present. Medicine can whiff a lot harder than healing magic, for one, and even with investment it takes a lot longer than ol' Hurt-B-Gone, especially in groups. Somebody that trains extensively in medicine being able to meaningfully heal wounds with their skill checks is good, in my view, and the fact it's something anyone has the capacity to train in removes the feeling some groups have that a party member with healing spells is mandatory to allow the party to progress through multiple non-speedbump encounters a day. For the most part in 1e wand of CLW was unquestionably one of the most useful adventuring devices while healer's kits were pretty useless without skill unlocks or extensive houserules; personally, I like "the party takes a moment to let the doc bind up their wounds and ensure everyone's fighting fit" as an image more than "the party groups up as the designated wand-wielders break out the stick o' life and magics all their injuries away."

Magic is still unquestionably what you'd do for in-combat healing in my book; even if you have Battle Medicine, healers' tools take two hands to use which means a ranger who's also a field medic is going to have to make some quick decisions vis a vis his crossbow and an injured ally while the guy with a Heal spell does not.

Making it easier for parties to patch up and keep going makes for longer adventuring days so you don't have to keep retreating from dungeons to rest, which just disrupts flow and isn't any fun. The GM will use the time needed to heal up to complicate the situation if they're wise, while the party doesn't feel like a bunch of babies who have to bail on a dungeon after a few rough fights or risk future encounters being more than they can handle.


Draco18s wrote:

My friend and I were in pretty solid agreement that the campaign was not going to work out in the long run as the GM wasn't adjusting the difficulty to account for the lack of magic and was more or less running a pre-written adventure with a quarter of the loot and not allowing spellcaster PCs.

The idea was nice, but the execution...didn't work.

yeah, that Gm was a jerk or ignorant of how big changes like that work. You are still playing a game, which has expectations and limits. If you remove magic, a GM in P1 needs to use Automatic Bonus progression, or dramatically reduce the encounter difficulty. A standard difficulty encounter should be thought of as Hard or worse. Baring those choices, a GM needs to allow their players to rest naturally for Days or Weeks.


Corvo Spiritwind wrote:


This skill reminds me of Darkest Dungeon, where the party actually settles down to rest. The survivalists can forage some food, craftsmen can repair gear and medics can patch the party up as the casters refocus. Isn't this the best case scenario for immersive adventuring?

This exactly! It is another example of maintaining usefulness to skills alongside magic. It also helps with verisimilitude. In our worlds where we tell our stories, which is more believable, common, and approachable by the common peasant or hero to be: A field medic patching you up with sutures, painkillers and poultices; or a hermit using rare and powerful magic to neatly and efficiently knit your gaping wounds shut?

They both exist, but one is ever present, encourages anyone with an interest and aptitude, and yet effective despite how long it takes. The other reminds us that we are playing a game. A metaphorical slap on the ass and "get back into the game, fighter".

Unless peasants are coming up to your PC clerics, sorcerers and Druids begging for miracles, I think Doctors need to be effective, otherwise casters will be mobbed, impressed upon or abducted.


Blackwaltzomega wrote:
even if you have Battle Medicine, healers' tools take two hands to use which means a ranger who's also a field medic is going to have to make some quick decisions vis a vis his crossbow and an injured ally while the guy with a Heal spell does not.

1) Battle Medic does not require healer's tools

2) Battle Medic does not require hands

Quote:

BATTLE MEDICINE [one-action] FEAT 1

GENERAL HEALING MANIPULATE SKILL
Prerequisites trained in Medicine
You can patch up yourself or an adjacent ally, even in combat.
Attempt a Medicine check with the same DC as for Treat
Wounds and provide the corresponding amount of healing.
As with Treat Wounds, you can attempt checks against
higher DCs if you have the minimum proficiency rank. The
target is then temporarily immune to your Battle Medicine
for 1 day

Note the lack of a "requirements" line. If you care to debate this, there's already a thread

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