Treat Wounds and Reliability - Am I missing something?


Rules Discussion


I've been through some issues regarding Treat Wounds during play, it seems to be too unreliable for a good adventure flow, breaks immersion and discourages pressing on.

I'm GMing Plaguestone with 3 characters: Melee Ranger with an animal companion, Crossbow Ranger and a Thief Rogue. Whenever Treat Wounds was needed, we felt something was off.

At 1st level, the three of them are trained in Medicine, sporting 12, 14 and 16 Wisdom for a total of +4, +5 and +6 Medicine. The idea was so everyone could heal themselves since we had no Cleric or similar character. Considering that, we are looking at 50%, 55% and 60% of success/crit success on Treat Wounds for Trained DC 15.

In a small group of 3, and I believe this would apply similarly on a default 4-player party, at least 2 of them (the melees, and sometimes the companion) would require healing after an encounter, sometimes all 3 would. The Boar encounter was specially damaging since it has high speed in conjunction with an accurate and strong Boar Charge move, which downed the ranged Ranger with a single blow.

A Treat Wounds failure heals nothing and puts the character in a 1-hour lockout from another try. After 3 consecutive failures (~10%, not that improbable), the character with 0 HP has yet to be able to stand. They spent a lot of time drinking tea with Trin while being bandaged for 30 minutes total in a span of 2 hours for... absolutely no effect, I could see the disappointment in my players' eyes.

Moments after this, everyone declared they were taking Assurance(Medicine) and/or Medicine related skill feats as soon as possible so the game would run better, if not for the mechanical effect, for the feeling that when they stop to heal, they are guaranteed to heal at least something.

Since I had already read all the module, just imagining Hallod's Hideout with such unreliable healing made shiver a little. With that in mind, I made a ruling on the spot. From now on, every time you Treat Wounds you heal for "success chance times 9 (4~5), doubled for 1h (8~10)", which would be something close to the average healing for 2d8 over time and promised to do some deeper math considering critical failures and successes and try to find a solution for that.

So, I bring this to my fellow players and GMs, am I missing something? Is this how it works? Have you had any problems similar to this?


It is a little unreliable at 1st level, but pretty quickly becomes much more reliable since proficiency increases at every level but the DC stays where it is until you can optionally increase it for added effect.

Beyond that, I think this comes down to attitude/expectations. For players like my group that don't expect to be able to heal-up much at all without spending limited usage resources, any healing that comes out of Treat Wounds actions is a bonus and failed Treat Wounds (or even no one being trained in Medicine) is met with "oh well" - but if the players are used to patching up significantly between encounters, I can see how Treat Wounds would disappoint.


All I can add really is that, Yeah low level its pretty unreliable, but as you level up it becomes far more usueful/reliable.
Which really feels like it should considering how profiency and experience in character works.

It is basically a "spend time vs spend resources" situation. resources on healing or time on the check. At low level you have very limited resources or you have in consistant chances. Thats.. kind of just wha low level does now since you're new to adventuring and such.

Ah, I will note that Aid becomes pretty nice. Though if you dont have Cooperative Nature then the DC 20 is probably not a great to attempt at lv 1. Or you might give a -1 if you roll very badly.

As a sidenote. If they pick up battle medicine and such you can also aid on those, so your players can pull some fun tricks mid battle.

but yeah lv 1-3 or 5 has a fair bit of swing, though I enjoy that myself, it makes me feel like I am actually a novice and learning how to do things. gives me a lot of fun RP space


Pathfinder Card Game, Companion, Starfinder Adventure Path, Starfinder Roleplaying Game, Starfinder Society Subscriber; Pathfinder Roleplaying Game Charter Superscriber

That sounds about right to me. As a side point, maybe it will pique the interest of a player to play a cleric, or some other healer-type.


It sorta makes sense to me as well .healin kits are not cheap. So I don't think they truly expect a lot of that.
Well unless the party pools cost anywaay.

There are a ton of healing choices at least, cleric, bard (sorta), sorcerer,, Alchemist (though this isn't great until the lv 5 version where it has decent minimum healing. low lv 1d6 is just painful)

Shadow Lodge

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Personally, I'm running a 'bandage spec' Thief* with a 16 wisdom, upgrading my Medicine skill to 'Expert' at level 2, and the following skill feats:

  • 1) Assurance (Medicine) (not useful at 1st level, but useful at level 2 and higher and you can take it at level 1, unlike the rest of these choices).
  • 2) Continual Recovery to allow for multiple treatments in a short time period, and
  • 3) Ward Medic so you can treat multiple people
It's a lot of feats, but Rogues get a ton of them and I'm not really planning on taking any more at the point. We do have a cleric in our group and he's taken most of the same feats (took Rogue Dedication at level 2 to get another skill feat), which means the party can bounce back pretty quickly after a fight.

*Back at the beginning of 'World of Warcraft' there were fights in the Molten Core raid that Rogues were so bad at that their best option was to use 'first aid' on more useful characters, which lead to the joking recommendation to take the 'bandage spec' for endgame raids...


I'm playing a crossbow ranger in Plaguestone (still level 1. I only skimmed your post because spoilers). My wisdom is 16 and I'm trained in medicine. I'll get assurance at level 2 and continual recovery at 3.

So far, I've had no problems treating wounds, though admittedly it hasn't been necessary all that often. Stillx by level 3 I'll be able to heal 2d8 every 10 minutes. At 6 (should we play beyond Plaguestone, which I believe ends at level 3 or 4) I can heal 2d8+10 every 10 minutes without fail.

Around level 8 with 18 wisdom and master medicine I'll switch back to rolling instead of using assurance. I'll have a good chance of success (for the DC20 version, that is) and even a decent change to crit for extra healing.

So yeah, treat wounds seems fine. Anyone can easily use it starting level 3. A rogue even starting level 2. High wisdom characters can get extra mileage out of it at many different levels but for basic healing, it's usable by anyone willing to invest a few skill feats.


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I'm with noble drake on that. Treat Wounds is not supposed to be able to put everyone to top between fights. It's just there to reduce the use of resources on healing.
Once you get Continual Recovery, it gets a bit better at treating between fights, but it still asks for quite some time that you won't have all the time.
So, in the case of your party, they need potions.


First of all, thanks for the answers.

I see and understand most of your points but 2 factors still bug me:

First, at the moment, I understand that PF2E assumes a (almost) full HP party before every encounter. Treat Wounds was created during playtest so that a healing font Cleric wasn't mandatory for all groups because of this assumption. A low level party does not have enough treasure to stock on potions so they can't reliably heal on a timely manner.

Second, how do you explain in-world spending 10 minutes for no results at all? Also followed by a 1-hour "cooldown". This bugs me the worst.

Medicine becomes a very powerful tool when you invest skill feats on it, but even the most skilled will (barring assurance), some percentage of the time, heal for absolutely nothing on a willing creature, outside of combat. It's very hard for me to swallow this but it seems I'm on the minority.

Sovereign Court

Pathfinder Roleplaying Game Superscriber
Sfyn wrote:
A Treat Wounds failure heals nothing and puts the character in a 1-hour lockout from another try. After 3 consecutive failures (~10%, not that improbable), the character with 0 HP has yet to be able to stand. They spent a lot of time drinking tea with Trin while being bandaged for 30 minutes total in a span of 2 hours for... absolutely no effect, I could see the disappointment in my players' eyes.

Not specifically related to Treat Wounds, but:

Unconscious wrote:
...If you are unconscious and at 0 Hit Points, but not dying, you naturally return to 1 Hit Point and awaken after sufficient time passes. The GM determines how long you remain unconscious, from a minimum of 10 minutes to several hours...

So that 2+ hours needn't have been so.

Grand Lodge

Sfyn wrote:

First of all, thanks for the answers.

I see and understand most of your points but 2 factors still bug me:

First, at the moment, I understand that PF2E assumes a (almost) full HP party before every encounter. Treat Wounds was created during playtest so that a healing font Cleric wasn't mandatory for all groups because of this assumption. A low level party does not have enough treasure to stock on potions so they can't reliably heal on a timely manner.

Second, how do you explain in-world spending 10 minutes for no results at all? Also followed by a 1-hour "cooldown". This bugs me the worst.

Medicine becomes a very powerful tool when you invest skill feats on it, but even the most skilled will (barring assurance), some percentage of the time, heal for absolutely nothing on a willing creature, outside of combat. It's very hard for me to swallow this but it seems I'm on the minority.

I'm right where you are Sfyn, so perhaps the minority isn't so small.

Liberty's Edge

Sfyn wrote:
pA low level party does not have enough treasure to stock on potions so they can't reliably heal on a timely manner.

I understand how that might bug you. Though I’m okay with lower level parties being a little more brittle, I know this doesn’t feel sufficiently heroic to everyone.

If you’re the GM, you might address this by peppering the world with some extra healing potions. I doubt that will hurt anything. You also might drop a set of Expanded Healer’s Tools to shore up the Medicine checks.

Quote:
Second, how do you explain in-world spending 10 minutes for no results at all? Also followed by a 1-hour "cooldown". This bugs me the worst.

I don’t really get why you’re bugged that failure is one of four possible outcomes. I’ve had experiences in my life where I’ve worked on some task for ten minutes and neither accomplished anything or screwed up so badly that I set myself back. The one hour cooldown is a little trickier, though, and I’ll grant it feels a little odd.


Can't help with the P2E assumption there, though I feel like the AP's i've played generally do give you time for stuff at least.

The no results bit doesn't bother me.
Functionally speaking you can patch up , bandage someone up all you want.. But if they've lost too much blood or have a concussion, or swelling from bruises, all the badnages or healing kits won't help that.

Sutures and such help your body heal up, but it can't replace lost blood, electrolytes, energy in general. Magic can--but which is why its the most reliable.

Portion of the increase in profiency is that your charcter is getting better and knowing what to do better. So for the above isntances, they might have filled their healing kit (during their last "auto refil") with blood restoration pill, or alchemical blood fillers, whatever fluff.
Which means you more properly treat the body in a way to help it restore itself, which is how it catches up withitself and such.
but even practices medics in the real world still commit errors.
But, after a point, you do get this following quote. So Granted that won't come up super quick. Though there is a provison later talking about GM's modifying DC to fit the situation.

"However, if you were going up against a very high DC, you might get only a success with a natural 20, or even a failure if 20 plus your total modifier is 10 or more below the DC. Likewise, if your modifier for a statistic is so high that adding it to a 1 from your d20 roll exceeds the DC by 10 or more, you can succeed even if you roll a natural 1!"

Sovereign Court

SuperBidi wrote:
Treat Wounds is not supposed to be able to put everyone to top between fights. It's just there to reduce the use of resources on healing.

I'm not convinced this is a categorical truth. It's a pretty big statement of opinion that there is one particular way you're supposed to let players use Treat Wounds as a GM.

I think rather that the idea is that in PF2 time between encounters is supposed to be a dial that GMs can twist to increase or decrease pressure. Note how there are a bunch of frequent 10 minute post-combat activities: repairing shields, recovering focus, identify magic items, and treat wounds. Several of these may take more than one try.

By giving or taking away opportunities to spend one or more 10 minute phases between encounters, GMs can increase tension or give a respite. You can do some easy encounters with no respite between them (making the total series harder) or give a longer respite before or after a big fight.

Players can also do things to increase their time, like laying false trails or finding hiding spots that give them more time to recover. The amount of respite could be the result of a skill challenge.

Shadow Lodge

SuperBidi wrote:
I'm with noble drake on that. Treat Wounds is not supposed to be able to put everyone to top between fights.

If you are willing to invest a feat or three, Treat Wounds is great for healing up the party: After a fight, you typically have a couple of folks searching for 10 minutes and then maybe identifying magic items for another 10, so it's not even adding much to your down time between fights...

Liberty's Edge

Pathfinder Companion Subscriber; Pathfinder Roleplaying Game Superscriber

How much healing could 2 1st level rangers and a 1st level rogue do in PF1? In D&D 5E?

Do they automatically succeed at everything else they try?

You have no magical healers in your party; you need to give them a back-up for the fact that their healing source is already a back-up source.


Sfyn wrote:

First of all, thanks for the answers.

I see and understand most of your points but 2 factors still bug me:

First, at the moment, I understand that PF2E assumes a (almost) full HP party before every encounter. Treat Wounds was created during playtest so that a healing font Cleric wasn't mandatory for all groups because of this assumption. A low level party does not have enough treasure to stock on potions so they can't reliably heal on a timely manner.

Second, how do you explain in-world spending 10 minutes for no results at all? Also followed by a 1-hour "cooldown". This bugs me the worst.

Medicine becomes a very powerful tool when you invest skill feats on it, but even the most skilled will (barring assurance), some percentage of the time, heal for absolutely nothing on a willing creature, outside of combat. It's very hard for me to swallow this but it seems I'm on the minority.

In-world, you can say the bandages and splints have been set as best they can, but will need to be adjusted in an hour as the wounds start to stabilize before you can do much more. If it didn't do anything now, the wound was more severe than your experience as a medic, but after 50 minutes of rest as the body relaxes some it may be more workable.


Ascalaphus wrote:
SuperBidi wrote:
Treat Wounds is not supposed to be able to put everyone to top between fights. It's just there to reduce the use of resources on healing.
I'm not convinced this is a categorical truth. It's a pretty big statement of opinion that there is one particular way you're supposed to let players use Treat Wounds as a GM.

Let me develop my thoughts.

If you don't have a dedicated medic, Treat Wounds will very quickly fade into nothingness (4d8 hit points every 70 minutes when you have hundreds of hit points is ridiculous).
Even with a dedicated medic, you will need nearly an hour to get a d10/d12 character from zero to full. So, in my opinion, you can't expect the DM to give you one hour of rest between all fights. If Treat Wounds is your only way of healing, you'll start some fights in a very bad state.

At low level, unless your party Rogue wants to increase Medicine at second level and take Continual Recovery and Ward Medic as soon as possible, you'll have to wait until level 6 to have a reliable way of healing through Treat Wounds. And that's if one of your characters increases Medicine at level 3, so considers it as his main skill.
By level 10, unless your DM restricts access to magical items, you should be able to buy a few dozens of Wands of Heal to use as your main healing shtick (you have 25 of them for the price of a level 11 item, 1000 for the price of a level 20 item).

So, Treat Wounds is really efficient during a quarter of your character progression. And even then, it can't be used alone. I make the assumption that Treat Wounds is not meant to be your main healing ability.

Sovereign Court

Interesting, hadn't seen that argument before.

Some quick math adds support to your theory. Let's say that our barbarian gets smashed to pulp but survives. And we have a low-wisdom goblin rogue surgeon. *looks at draft PFS character pile*

At level 6 our barbarian has Con 16 and 8+(6*15)=98 HP
Our doctor can do Expert DC healing with Assurance and Continual Recovery for an average 19 HP per 10 minutes. It takes a bit over 50 minutes to heal the barbarian.

After that the rate drops, because the next step up in DC is 10 more and with Legendary+Assurance we won't get there until level 13. Until then it just keeps taking almost 10 minutes more per barbarian level to fully heal this way. At level 12 the barbarian has Con 18 and 8+(12*16)= 200hp, which takes more than 10 Treat Wounds actions to heal.

At level 13 the rogue gets Legendary medicine and he can do the DC 30 on Assurance, so now he's healing 39hp per 10 minutes against the barbarian's 216HP so we need only 6 rounds of Treat Wounds.

---

Now, part of this is due to Assurance, it blocks off using Wisdom and getting item bonuses, so we're rather slow getting to the tipping points for using higher DCs.

I think most of the time you can count on one round of Treat Wounds after a battle (while people regain focus, repair shields, and identify loot), and maybe 1-2x extra. But 6-11x treat wounds per battle is unlikely. Of course, PCs aren't supposed to burn through their entire health each combat either.

But getting some other supplementary healing is definitely going to be needed.


Ascalaphus wrote:

Interesting, hadn't seen that argument before.

Some quick math adds support to your theory. Let's say that our barbarian gets smashed to pulp but survives. And we have a low-wisdom goblin rogue surgeon. *looks at draft PFS character pile*

At level 6 our barbarian has Con 16 and 8+(6*15)=98 HP
Our doctor can do Expert DC healing with Assurance and Continual Recovery for an average 19 HP per 10 minutes. It takes a bit over 50 minutes to heal the barbarian.

After that the rate drops, because the next step up in DC is 10 more and with Legendary+Assurance we won't get there until level 13. Until then it just keeps taking almost 10 minutes more per barbarian level to fully heal this way. At level 12 the barbarian has Con 18 and 8+(12*16)= 200hp, which takes more than 10 Treat Wounds actions to heal.

At level 13 the rogue gets Legendary medicine and he can do the DC 30 on Assurance, so now he's healing 39hp per 10 minutes against the barbarian's 216HP so we need only 6 rounds of Treat Wounds.

First of all: A skill becomes Legendary at level 15, not 13.

I know you were going with Assurance here, but a high Wisdom character can use Medicine much more effectively. At many levels it's actually better to roll than to rely on Assurance. And with wisdom being as important as it is, it's probably also not too hard to find someone with Wisdom 16 or 18 in any party by level 10.

A Wis-based character at level 10 can have +23 to Medicine (16 Master Proficiency, +5 Wisdom, +2 Healer's Gloves).

For the DC 30 check, that's 30% failure*, 50% success and 20% crit success . I'm not great with probability in math but I think that would bring the average healing to (39*50%) + (48*2*20%) = 29,1.

That's enough to get the level 12 barbarian fixed up within 70 minutes. A barb at your level (10) is fixed within an hour. And you can Multiply this healing with Ward Medic, getting the whole party going in one hour.

For something that's essentially free, this seems good enough to me. Someone relying solely on Assurance will be behind, but that's true for all skills.

*I'm ignoring Critical Failure here. Adding it to the equation would reduce the healing by the marginal amount of 0.225 healing done.


Add skill feat accuraccy for medicine, get expert in medicine and you always succed DC 15 at lv 2. 10+6=16
DC 20 at lv 6. 10+10=20
Or later level if you wait with expert.
With Continual Recovery and Ward Medic
You can heal two targets each 10min for 2d8 healing at lv2-3 and at lv 6-7 2d8+10, pretty good i would say without risk.


Pathfinder Rulebook, Starfinder Adventure Path, Starfinder Roleplaying Game Subscriber

I have always though people under estimated treat deadly wounds or just automatically dismissed because of 1E. You get the healers gloves or the expanded healer's kit this gives bonus to medicine as well as healers gloves giving other way to heal.


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I am personally pretty happy with where treat wounds is, as fully healing between encounters without expending spells or potions isn't something I am very fond of. I feel like the game is more tense and challenging if there is a significant cost to fighting an encounter that makes the next encounter more difficult by way of expending resources. The battered and bruised hero going into the final fight is far more interesting to me than someone fresh and fully healed doing so.

Heck, this expenditure of resources is generally the purpose of the smaller encounters that can't actually threaten the lives of the players on their own.


By level 3 anyone with assurance will auto succeed (level 2 for rogues). At low levels you can nab yourself battle medic to help for when a check fails.

Level 2 and 3 also open up continual recovery (checks eveyr 10 minutes).

In my expeirence with what paizo has released so far it has worked out fine though.

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