D&D 5E In-Combat Healing: How and Why?

Tony Vargas · Jun 19, 2019

TwoSix said:
That's a small part of it, but not the major portion. Even if cure wounds healed for double its current amount, you still wouldn't cast it until the target was near death. It's just more efficient that way.

Yes, you may goad monsters into Overkill and 'waste' their damage or 'gain' let's-pretend-healing damage due to heal-from-0.

The best way to get people to want to heal is to penalize being injured. Maybe bring back the 4e bloodied condition at half HP,and have bloodied targets attack with disadvantage. (That might be too harsh, so you could adjust the threshold to a third or a quarter if you wanted.)

Sure, bloodied, even without disadvantage, did that for most characters - monsters could be more dangerous when you were bloodied, for instance, without having to actually gimp you into some kind of death spiral.

But, I don't think penalties are necessary: just getting rid of heal-from-0, just counting the negative hps, alone would do it, because the 'bonus' is gone.
Of course, a lot of casters would let their dropped allies sit there and bleed rather than waste a decent-level spell, anyway...

cmad1977 · Jun 19, 2019

The answer is: In combat healing has its place and can be a valuable tool.

TwoSix · Jun 19, 2019

Tony Vargas said:
Yes, you may goad monsters into Overkill and 'waste' their damage or 'gain' let's-pretend-healing damage due to heal-from-0.

Yep. The 0 hit point cushion means a kobold doing 1d3 and an ogre that does 2d10+8 are the same level of threat when you're at 1 HP. If the ogre had a decent chance of killing you outright (by pushing you close to negative max), then your attitude to healing shifts.

Tony Vargas said:
Sure, bloodied, even without disadvantage, did that for most characters - monsters could be more dangerous when you were bloodied, for instance, without having to actually gimp you into some kind of death spiral.

But, I don't think penalties are necessary: just getting rid of heal-from-0, just counting the negative hps, alone would do it, because the 'bonus' is gone.
Of course, a lot of casters would let their dropped allies sit there and bleed rather than waste a decent-level spell, anyway...

Yea, it's probably not necessary to use bloodied. You could go with a "carrot before stick" approach, and have your common combat heals give a buff + heals. Like cure wounds gives the target advantage on their next attack. Or healing word only gives the target casting mod HP back, and the dice roll becomes temporary hit points. But that was probably too much like 4e back in 2014.

CapnZapp · Jun 19, 2019

cmad1977 said:
The answer is: In combat healing has its place and can be a valuable tool.

Yes.

This says very little, however.

It neither confirms not contradicts the notion that in combat healing needs to occupy a larger place and be more valuable before it gets used with any frequency.

CapnZapp · Jun 19, 2019

Tony Vargas said:
Of course, a lot of casters would let their dropped allies sit there and bleed rather than waste a decent-level spell, anyway...

Well, the cost of not helping your allies will sooner or later be losing a battle...

Except if we give these casters the benefits of the doubt they might do so because that spell can end the enemies.

Which of course is my way of saying that in 5E it is a common occurrence that you're better off killing the enemies than healing your friends even as a Cleric; that the former ends up saving more of their precious hit points than the latter.

Counter-intuitive some might say. Not really I would say.

LordEntrails · Jun 19, 2019

TwoSix said:
... It's that the penalty for hitting 0 is too small,

Agreed.

CapnZapp said:
... I detest the way the game is currently set up to encourage you to do Healing Word on just-fallen allies...

Yep, but...

TwoSix said:
...The best way to get people to want to heal is to penalize being injured. ...

Yep, and their is an optional rule for this in the DMG...

Dausuul said:
This is really more dependent on the DM than anything else. ...

Exactly.

Actually 2 optional rules that really fix most of this.

1) Re-roll initiative. The healer can now never be certain if they are going to be able to heal before the allies turn, so they start acting proactive/protectively.

2) Lingering wounds. Now their is a penalty every time a character goes to 0. One that lasts. So again they players start worrying about it and the healers start being protective healers.

Protective healers require in-combat healing.

And, if the DM starts being a little more ruthless, or just stops protecting unconscious characters, now AoEs starts including downed character when applicable and the troll/ogre/orc/etc bashes the downed PC 2 or 3 times because they might not be smart, but they are wise enough to know that if they leave the paladin/barbarian/etc unconscious on the ground one of his stupid friends is going to use magic to make him jump right back up. Instead they just did a lot of work to get that guy down, and they sure as heck are not going to let him get back up.

Kobolds and goblins? Sure, they don't know better, but you don't survive a handful of fights with adventurers and not know what's going to happen if you don't kill them.

"Damned things are like roaches, smash them once and they will just get back up. You got to stomp them, then stomp, stomp, STOMP!" - Ergo, the Ogre

Stalker0 · Jun 19, 2019

To me the two simplest rules to fix this:

1) a penalty when falling unconscious. That way you always take some pain.

2) a person who falls unconscious always loses their next turn, no matter when healed. This means initiative is less relevant. Right now if I drop and the healer goes before my next turn, I’m barely inconvenienced. But if I lose my turn regardless of when I’m healed, it’s a big deal.

FrogReaver · Jun 19, 2019

Baldurs_Underdark said:
Whether high-level healing is worth it, I am not so sure. Killing an enemy also removes damage from the game, because that enemy will not deal damage anymore the next round.

Assuming know you have a sure fire 100% guaranteed chance to end the combat then ending the combat is better than healing. That's generally not the case though. There is always a bit of a fog of war if you will. I can attack and try to kill the enemy now, not knowing if I will even hit it, if I will do enough damage to kill it etc or I can guarantee that my injured ally that might be hit and dropped to 0 hp the very next round is instead guaranteed another round or 2 before that happens.

Of course what if the enemy is still another 2-3 rounds from death. Should you still attack and risk your ally dropping? Is that really the better tactic?

(Keep in mind this about a large 1 action in combat heal vs trying to cast low level healing spells every round (I agree those aren't worthwhile)

In the action-economy, I always feel that healing is a waste of time. When there is a brief intermezzo between fights however, healing is very valuable. I never did the math, but I generally feel safer when the enemies are slain.

The tactics I'm proposing are not asking you to stop attacking for most of any given fight. Instead my tactics only have 1 requirement. 1) Hold some high level slots for in combat healing for when an ally has potential to drop the next round and use them at that time for healing.

Is it better to not heal an ally in that kind of situation? I don't think so.

FrogReaver · Jun 19, 2019

TwoSix said:
I just don't see a way that in-combat healing can be an effective strategy within the current rule set and general metagame assumptions. It isn't just a question of resource efficiency. It's that the penalty for hitting 0 is too small,

D&D is a team game. When you heal your team isn't hitting for 0.

the window from being unconscious to dead is pretty large,

Sure, but why take that chance in the first place when you don't have to?

and that at most tables,
the penalty for actually dying isn't that severe. (Have a new character ready for next session!)

It's not mechanically severe. Assuming you enjoyed your character then losing him is a fairly severe consequence.

If characters dies at -10 HP, and replacement characters always started at level 1 with no magic items, and the entire metagame would shift to favor healers, high AC characters, and temp HP granters.

Sure. I'm not really looking for ways to alter the game. I'm taking the stance that in-combat healing in 5e is underrated provided you adopt the tactics for doing it that I've outlined in this thread.

You can definitely do it wrong. Trying to use your low level slots in combat to heal is doing it wrong. Using your in combat turn to heal and ally that isn't in any danger of dropping next turn is also doing it wrong.

Instead the way to make in-combat healing work, is to
1) Limit the number of actions you spend healing
2) Only use in-combat healing when it's going to immediately reduce the risk of an ally being downed next turn.

FrogReaver · Jun 19, 2019

CapnZapp said:
While there certainly is nothing wrong with a game encouraging combat healing, the 5E devs went another route.

That is, 5E was deliberately tweaked to limit combat healing. I wouldn't go into why, since that's not what you want this thread to be about.

What you *do* want to discuss can be one out of two things, as far as I can see:

1) How to make combat healing work given the current game, no changes made. Unfortunately here I have no suggestions, so I'll simply leave you to it.

2) How to tweak the game's parameters so in-combat healing is once more a thing. Be sure to tell me if this is the case.

As for whack-a-mole, I detest the way the game is currently set up to encourage you to do Healing Word on just-fallen allies, making you huge savings in surplus damage. I had to add as a house-rule that you count negative hit points (down to -10). This significantly hampers the whack-a-mole tactic, since a first level slot's worth of Cure Wounds or Healing Word is not enough to reliably take you all the way from -10 hp to a positive number.

It's weird that you don't ever engage with my challenges and instead just reassert the conventional wisdom on the matter as if it's a god given fact of gaming.

I proposed a particular tactic to in-combat healing. Why is it that you think that tactic won't provide the results I'm claiming it will?