New Rogue Archetype: The Physician (Expert in Medieval Medicine)

I think a very important, but poorly-represented character concept is that of the skilled healer, someone who more closely represents what a healer in a medieval setting is actually like. The Player's Handbook includes the healer feat, but I wanted this archetype to not rely at all on the feat, but at the same time be completely compatible with anyone who wants to take it. I felt the Rogue class was the best fit for the archetype, as the rogue class in 5th Edition emphasizes expertise in potentially any of the skills available. Thoughts on play balance and phrasing are appreciated.

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You take the Rogue’s emphasis on precision and perfecting their skills down a very different path. Perhaps from formal training, or perhaps out of the circumstantial necessity that pulls most rogues through life, you have picked up the physician’s healing art. This is not the miraculous power of devout men to erase wounds and raise the dead, but the gruesome and practical science of medicine. Your talents as a physician will help you to identify and cure afflictions, promote the long-term longevity of yourself and others, and brew bizarre tonics and potions with the expertise of a learned sage.

Doctor of Physic
When you choose this archetype at 3^rd level, you gain proficiency with the herbalism kit and the Medicine skill. You can use the bonus action granted by your Cunning Action to make a Wisdom (Medicine) check, take the Use an Object Action (But only to use a potion, or anything that can be created with an herbalism kit, on yourself or someone else), or use your healer’s kit.

Bone Setting
Starting at 3^rd level, during a short rest you can treat a number of patients (potentially including yourself) equal to your Wisdom Modifier (Min. 1). A patient under your care who spends hit dice to restore hit points gains extra hit points equal to your Wisdom Modifier (Min 1.) at the end of the short rest, and can reroll any hit dice that roll a 1. Patients must use the new roll, even if the new roll is a 1.

Bloodletting
Starting at 9^th level, by balancing the elemental humors in a patient’s body, you can cure a wide range of illnesses. You can make a Wisdom (Medicine) check as a bonus action and force a creature within 5 feet (Or yourself) to spend a hit die. Instead of regaining hit points they lose that much health, and if the result of the medicine check beats the save DC of an effect that inflicted a disease or caused the blinded, charmed, deafened, paralyzed, or poisoned condition, end that disease or condition.

Alchemy
By 13^th level, you have become experienced in producing the strange remedies and potions peddled by apothecaries and alchemists. For the purpose of brewing potions, you are considered to be a spellcaster with levels in a class with spell slots equal to a third of your rogue level. The time and gold you must spend to brew potions, and to create antitoxins and other formulas with your Herbalism Kit, is halved.
Additionally, you gain expertise in your Herbalism Kit.

Faith Healing
When you reach 17^th level, your experience and reputation as a Physician allows your first and last resort in the healing arts, prayer, to have some measurable effect, even if there is no true magic behind it. As a bonus action, you dramatically pray for the intercession of a higher power in protecting and healing an ally. Choose one friendly creature other than yourself within 60 feet of you who can hear you. That creature gains temporary hit points equal to 1d4 + your Wisdom modifier (Min. 1). As long as these temporary hit points last, the creature who has them has advantage on Constitution and Charisma saving throws. Only one creature can have temporary hit points from your Faith Healing feature at a time.
Additionally, a patient under your care who spends hit dice to restore hit points can reroll any dice that roll a 1 or 2. Patients must use the new roll, even if the new roll is a 1 or 2.

Mostly, I like it, but I feel that for purposes of balance, some of the features are a little over-powered.

1. Bone Setting. I would limit the re-roll to just on an original roll of 1, keeping the proviso that if the result of the re-roll is also a 1, it must be kept.

2. Alchemy. The spell slots for brewing potions should only be equivalent to the number of spells slots that an Arcane Trickster of the same rogue level would have. This would limit the 13th-level rogue-physician to potions of superior healing at most (but see notes on Faith Healing below).

Also, halving the cost in time and coin to brew potions, create anti-toxins, etc., may be bit too generous. I would grant the reduction in cost, but keep the standard time needed for brewing, since your opening statement was that your vision for this archetype was for a kind of nuts-&-bolts, non-magical healing art.

-OR- halve the brewing time as you stated, but the efficacy of any healing potion would be in temporary hit points, representing the rushed nature of the brewing.

3. Faith Healing. Again, given the non-magical healing aspect, perhaps you should remove the allusion to prayer and instead stick to the more pragmatic brewing action. This archetype feature would allow the rogue-physician to brew the more powerful potion of supreme healing that would otherwise not be allowed due to the PC's limited spell slot levels. I'd keep the 10d6 temporary hit points aspect as you stated.

Having advantage on all abilities strikes me as being in the unbalanced category. I advise limiting advantage on saving throws to Strength, Constitution, and Charisma, representing the physiologically "juiced" condition of the creature the PC treated, but Dexterity, Intelligence, and Wisdom, while not disadvantaged, would be abilities more likely to be adversely effected (i.e., more twitchy than dexterous, and too physically amped-up to excel at analytical thinking or to exercise the best common sense).

As with Bone Setting, I'd reduce the re-roll option a bit to only occur on original die rolls resulting in a 1 or 2.

All offered in my less humble than I should perhaps be opinion.

I like the flavor, and I understand the basic reasoning behind making this a rogue archetype, but still:

What's the justification for a physician character having access to basic rogue abilities like Sneak Attack and Cunning Action?

I've been toying with the idea of fitting in this sort of physician (or more specifically, a medieval plague doctor) into a D&D setting, but my approach was to design it as a background rather than a class. I also have a PC Transmuter Wizard who is a physician, with the medicine feat. I'm not necessarily opposed to making the physician into a class, but I'm not sold on making it into a Rogue archetype.

This concept re-enforces my desires for a spell-less bard.

empireofchaos said:

I like the flavor, and I understand the basic reasoning behind making this a rogue archetype, but still:

What's the justification for a physician character having access to basic rogue abilities like Sneak Attack and Cunning Action?

I've been toying with the idea of fitting in this sort of physician (or more specifically, a medieval plague doctor) into a D&D setting, but my approach was to design it as a background rather than a class. I also have a PC Transmuter Wizard who is a physician, with the medicine feat. I'm not necessarily opposed to making the physician into a class, but I'm not sold on making it into a Rogue archetype.

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It seems to me that a physician's Sneak Attack ability would be informed by a knowledge of anatomy and, from proficiency with the herbalism kit, various toxins. A related question: in the physician's game-world culture, is there the equivalent of the Hippocratic Oath?

Regarding the relation of Cunning Action to this archetype, Dash makes sense in an emergency-room or field-medic context.

Likewise, I don't see any reason to remove Disengage from the feature; breaking away from a foe in combat to care for a fallen ally matches up well.

Hide, however, does not fit the archetype so easily: a physician focused on a patient would naturally be less focused on other things, and the motions needed for attending to the patient could likely even draw attention to the physician. For a rogue-physician, I would replace the Hide bonus-action option in Cunning Action with the ability to use the Wisdom (Medicine) check or a healer's kit.

Empireofchaos, I'm interested in your build for a physician background. It could be cobbled together as a hybridization using elements of Guild Artisan and Hermit, but other possibilities exist, so I'd appreciate seeing what you've come up with.

Your feeling that a Physician archetype doesn't seem to go with the Rogue class makes some sense. I can see your point there.

That being said, I am nevertheless increasingly inclined to experiment creating PCs of one class and adapting an archetype from another class just to see if the results are balanced and playable. [Obviously not for AL play.]

Hide is justifiable for a physician, to me. They're primarily a non-combatant, and probably lightly equipped. It would be naturally easier for them to hide than for many other classes. Throw in that they're inherently close-range characters due to the need to get right up next to someone to treat them, I think it fits fine. Remember that this is necessarily a physician that is somewhat combat-hardened, as opposed to an NPC doctor with no class features, by virtue of being a player class. It doesn't need to represent every Joe Blow physician.

The feature that I would have a problem with is Thieves' Cant (though TBH I think it's a poor feature regardless). My instinct would be to houserule this feature into a bonus language proficiency with the Cant as an option, and that would also work for the physician (better educated, I guess; or they use such a code to talk to the sketchy types who fetch bodies for their studies).

I agree with Redthistle, mostly. Especially on Faith Healing, that was a huge raised eyebrow for me. Even with the note that it might be psychosomatic, for the most potent healing option of an otherwise mundane Rogue doctor to be "out demons, out!" is really disharmonious. You could justify a similar effect with a drug that numbs the target to pain, or something similar.

One small note: Bloodletting doesn't mention an action cost. Presumably this could be your Cunning Action? Is it an action otherwise?

You could always rename it Field Medic?

Instead of picturing a doctor, consider the rogue has received medical training and is capable of moving across a battlefield more efficiently to aid his/her comrades.

Level 3: You gain proficiency with Herbalism Kits. Once per short rest when you stabilize a friendly creature they receive 1 hit point.
Level 3: Triage. Your knowledge of precision and anatomy can be used to heal a friend as effectively as you would harm a foe. You may spend an Action to heal a friendly character within 5' a number of hit points equal to a sneak attack roll. Once you use this feature it cannot be used again until you finish a long rest.
Level 9: Quick Thinking. You may use your cunning action with the use an object action, provided it is to administer a potion to yourself or someone else.
level 13: Pharmacology. As an Action you may use a Herbalism Kit to attempt to treat any poison or disease with a (wisdom) medicine check. If you fail to cure a person of one such illness you may not attempt to cure them again until after a long rest.
Level 17: Surgical Precision. Any time you deal sneak attack damage to a creature it must make a Constitution DC (8 + prof + wis) or suffer disadvantage on it's next attack roll.

Wow, lots of great discussion here! I really appreciate it!

Redthistle said:

I would limit the re-roll to just on an original roll of 1

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Haha in my original personal draft, I actually had max health restored whenever a rest hit die was used. I gave it some thought and realized that was crazy-overpowered for a level 3 class feature (Almost equal to the life cleric, the ultimate healer's, level 17, so I didn't think much about reducing it to only on a 1 or 2. I can see what you mean though and I think I will change the re-roll to only happen on a 1 at 3rd level and on a 1 or 2 at 17th like you suggest.

Redthistle said:

2. Alchemy. The spell slots for brewing potions should only be equivalent to the number of spells slots that an Arcane Trickster of the same rogue level would have. This would limit the 13th-level rogue-physician to potions of superior healing at most (but see notes on Faith Healing below).

Also, halving the cost in time and coin to brew potions, create anti-toxins, etc., may be bit too generous. I would grant the reduction in cost, but keep the standard time needed for brewing, since your opening statement was that your vision for this archetype was for a kind of nuts-&-bolts, non-magical healing art.

-OR- halve the brewing time as you stated, but the efficacy of any healing potion would be in temporary hit points, representing the rushed nature of the brewing.

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Ah, I see what you mean here regarding the rogue spell slots (Especially with how multi-classing interacts with the arcane trickster and other classes) so I will definitely change that. Magic item creation is still a slow and expensive process in 5e (Though I certainly don't think that's a bad thing as a whole) and I'm not sure that this part of the ability is such an issue. Nonetheless I will give it some thought, and I really like your alternative suggestion of quickly creating healing potions, but they only grant temp hp. It kinda goes well with the pseudo-placebo effect of medieval medicine and ideally the kind of flavor I'm especially trying to capture with faith healing. Speaking of...

Redthistle said:

3. Faith Healing. Again, given the non-magical healing aspect, perhaps you should remove the allusion to prayer and instead stick to the more pragmatic brewing action. This archetype feature would allow the rogue-physician to brew the more powerful potion of supreme healing that would otherwise not be allowed due to the PC's limited spell slot levels. I'd keep the 10d6 temporary hit points aspect as you stated.

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I like this suggestion as an alternative in terms of keeping the game mechanics but having a very different flavor. As far as my limited understanding of the historical medieval period goes (Like the very anachronistic plague doctor pictured above), diseases were believed to be a spiritual affliction, a punishment from god, and so praying god for forgiveness was the most common "Practice" in alleviating and curing illnesses. I'm going to keep this feature as faith-healing, which I believe is important to have a complete medieval-style physician, but between yours and Macv12's comments:

Macv12 said:

I agree with Redthistle, mostly. Especially on Faith Healing, that was a huge raised eyebrow for me. Even with the note that it might be psychosomatic, for the most potent healing option of an otherwise mundane Rogue doctor to be "out demons, out!" is really disharmonious.

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I can see that the ability as-presented is a little bit immersion-breaking in how dramatic a boon it provides despite being more or less psychological in nature. I think I will change faith healing to instead provide 1d4+WIS temp HP and provide advantage on Constitution (Protection from diseases and poison) and Charisma (Protection from possession by demons and evil spirits) saving throws instead. Rather than being 1/long rest, it can be used infinitely as an action, but only 1 creature can have temp hp granted by this feature at a time. This is very similar to the Warlock invocation "Fiendish Resilience," but instead of only working on you, it can only be used on someone else.

Macv12 said:

One small note: Bloodletting doesn't mention an action cost. Presumably this could be your Cunning Action? Is it an action otherwise?

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Ah good catch! It is supposed to be compatible with Cunning action because it is a medicine check, but I should specify that in the feature's description.

dmnqwk said:

You could always rename it Field Medic?

Instead of picturing a doctor, consider the rogue has received medical training and is capable of moving across a battlefield more efficiently to aid his/her comrades.

Level 3: You gain proficiency with Herbalism Kits. Once per short rest when you stabilize a friendly creature they receive 1 hit point.
Level 3: Triage. Your knowledge of precision and anatomy can be used to heal a friend as effectively as you would harm a foe. You may spend an Action to heal a friendly character within 5' a number of hit points equal to a sneak attack roll. Once you use this feature it cannot be used again until you finish a long rest.
Level 9: Quick Thinking. You may use your cunning action with the use an object action, provided it is to administer a potion to yourself or someone else.
level 13: Pharmacology. As an Action you may use a Herbalism Kit to attempt to treat any poison or disease with a (wisdom) medicine check. If you fail to cure a person of one such illness you may not attempt to cure them again until after a long rest.
Level 17: Surgical Precision. Any time you deal sneak attack damage to a creature it must make a Constitution DC (8 + prof + wis) or suffer disadvantage on it's next attack roll.

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Some interesting ideas here. I really like your Quick Thinking feature to Use an Object to administer a potion to yourself or someone else. I'm not sure that on its own is worth an entire 9th level feature, so I'll think about folding that into one of the other features. I think your field medic would make a good fighter archetype (Being more of a soldier). The flavor of the Physician as being distinctly medieval-style is extremely important to me and I will keep the name Physician as-is. Your level 3 feature of 1/short rest a stabilized creature regains 1 hit point is almost identical to a boon of the healer feat, and I want this archetype to be completely compatible, and simultaneously completely independent from the healer feat and the optional feat rules.

Your surgical precision feature reminds me of a feature I considered giving my physician either called "Plague Doctor"
"Starting at 3rd level, your advanced medical knowledge makes you as good at spreading sickness as you are at treating it. When you deal extra damage with your Sneak Attack feature, you can change the extra damage to deal Poison damage. When you deal Poison damage with your Sneak Attack feature, the target must make a Constitution saving throw (DC 8 + your Wisdom modifier + your proficiency bonus) or be poisoned until the end of its next turn."
As I kept thinking of more abilities, this felt like the least important to me though so it hit the chopping block.

Redthistle said:

in the physician's game-world culture, is there the equivalent of the Hippocratic Oath?

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A physician trained in a formal school would probably take something resembling the hippocratic oath. On the other hand, this physician kind of folds together all the different "Healing Practices" of the middle ages into one character that would be more traditionally separate occupations, mainly the bone-setter, apothecary, actual physician, and to an extent the priest.

There's been a lot of comments on whether the rogue is a good fit for the physician. I don't think its a perfect fit, but from the core class options the PHB offers, I definitely think its the best one. I really admire 5th edition's Rogue because the rogue's expertise can be used with any skill you know, giving a huge breadth of character concepts that can be cobbled together using the rogue. A Rogue with expertise in athletics and intimidation could be a thug, and a Rogue with expertise in persuasion and history (With the Swashbuckler domain) could be a cultured noble. Being a rogue also adds something of a slightly sinister touch I like when coinciding with some of the really brutal work they have to do. The only other class we currently have I would even consider for the physician would be the fighter, but I think the rogue is a much better fit. If the Factotum class from 3e ever got re-released, that would probably be the best place for the physician.

Plague Doctor background

Redthistle said:

Empireofchaos, I'm interested in your build for a physician background. It could be cobbled together as a hybridization using elements of Guild Artisan and Hermit, but other possibilities exist, so I'd appreciate seeing what you've come up with.

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Well, now you've forced me to finish it.

It's not properly speaking a physician background, but specifically a plague doctor background (though it may be more broadly applicable in some of its aspects.

Attached and pasted.

Plague Doctor Background

You received some training as a physician, but were thrust into the front lines of fighting a deadly plague epidemic that struck at your city with some regularity. Every day, you went forth to do battle against the pox, armed with your scalpel, your leeches, and your caduceus, and protected by your full-length dark robe, brimmed hat, and a waxed mask with glass eyes and a beak containing spices that is supposed to serve as a filter against the “bad air” generated by the disease. As you were employed by your city, you had to take an oath of service that required you to follow a physician’s code, and you had to treat everyone – the rich as well as the poor. But you also had to learn how to navigate the city’s bureaucracy, how to stay (relatively) safe and sane, and how to make sure you got paid. Since you knew the majority of your patients were going to die regardless of what you do, you and your fellow plague doctors developed a unique outlook on life that combined self-interest, altruism, fatalism, and a quaint egalitarianism born of the fact that the plague recognized no social distinctions.

Skill Proficiencies: Medicine, Nature
Tool Proficiencies: Chirurgeon’s tools
Equipment: A set chirurgeon’s tools, a plague doctor’s leather outfit (including mask), a vial of live leeches (or frogs), a caduceus (usable as a spell focus), and a pouch containing 10 gp.

Feature: The Grim Reaper’s Herald
If you are sighted on the streets of a city dressed in your plague doctor’s regalia, people are likely to assume the worst. You may be able to clear the streets, and perhaps to enter restricted places if you make a believable claim you are there to treat a plague victim. You are also one of the few people who can legally handle corpses and perform autopsies.

d8 Personality Trait
1 You take your work and oath seriously, and would like to be treated as an authoritative professional
2 You know that your profession is a mere fraud, and this colors your outlook on life in general
3 You are not above lifting a few valuables here and there – their owners are probably not long for this world, and won’t need them anyway
4 You use your position to befriend rich people you treat – it might come in handy
5 You know a few secrets and scandals involving your city’s administration
6 The only way to stay sane at a time like this is to live life to the fullest every waking moment
7 You believe yourself invulnerable to the Plague, and other things as well
8 You think you have insight into the meaning of the Plague, and invent various apocalyptic theories on this score

d6 Ideal
1 Bon Vivant. Enjoy yourself – it’s later than you think (Chaotic)
2 Salvation. I work to save people, and by doing so, perhaps make myself worthy of being saved as well. (Good)
3 Rules. If you don’t follow proper protocol, things would be even worse (Lawful)
4 Judgment. I have the power to decide who lives and dies – as I should (Evil)
5 Fate. We have no control over the forces that govern life and death (but we might glimpse signs of Destiny if we look) (Neutral)
6 Aspiration. I work hard to make a difference (and a name for myself) (Any)

d6 Bond
1 I have lost my whole family to the plague, and don’t know why I was spared
2 I know the source of the Plague, but I’m prevented from making this knowledge public
3 I have recently learned of a miraculous cure (but it is hard to get)
4 I don’t like it when the powerful put on airs – the great and the lowly stand equal before Death
5 My master had high expectations for me as a physician, but in becoming a mere plague doctor, I have failed him
6 If you want to get results, take your oath seriously, and do everything by the book

d6 Flaw
1 Sometimes it is better to put people out of their misery
2 I have a compulsion to use my position to enrich myself and my family
3 I have become a thrill seeker, and like to tempt Death
4 There are definitely scapegoats to blame for the Plague and other things going wrong
5 I’m jealous of others’ skill and accomplishments, and look for ways to make them mine
6 I dabble in divination, perhaps a little too much

What about chirurgeon or vivisectionist?