D&D 5E (2024) Improving Medicine - one of the least loved skills.

[TheSword]

My previous thread D&D 5E (2024) - Rank 5e skills from most useful (1) to least useful (18) generated a some discussion and a bit of disagreement but one thing that was almost unanimous was the feeling that Medicine and Performance were the two least used/useful skills in D&D 5E (2024). I find this particularly ironic as in my online WFRP group I have a Doctor and an Entertainer PC that are using those skills continuously. It made me think about how could we make these more relevant or useful in 2024 D&D 5E. I think its possible, perhaps even desirable to do so if the DM and the PCs agree.

Its also ironic because entertainment and health seem to be two of the most important things in our lives. We certainly spend trillions on them every year and spend a lot of our time thinking about them. I don't think its coincidental that of all the skills in the list - IRL these two are the highest paid!

Its also interesting that both these skills are vocational - they both relate to a profession (doctor/healer/midwife or entertainer/actor/performer). Most professions have their skills covered by Tool Proficiency - alchemist, stone mason, chef etc but Medicine and Perform are singled out and added to the core list. For good reason I think. There is something special about these skills.

5E Medicine

I thought I would start of with medicine and discuss what the skill already does in the 5e rules. From the 2024 PHB the examples are...

Diagnose an illness, or determine what killed the recently slain.

That's pretty short and sweet. As most PCs ARE what killed the recently slain in most adventures, I can see why this would not be very helpful.

A really important change is that Lesser Restoration no longer cures Disease. That part was removed from the spell description. It also doesn't cure poisons - it removes conditions including poisoned. These are not quite the same thing! There is a niche here to be explored!

What's brought you in today? - Diagnosing Illness
Diagnosing an illness is a pretty niche task but in certain encounters I can see it being very useful. Particularly if you are playing the D&D version of Cadfael in a murder mystery scenario... circumstantial at best though. Some other uses might include

• A general understanding of health. How to live a healthy lifestyle - improving the health of a community
• Easing the care or condition of an Elderly or infirm NPC
• Delivering a child (pregnancy isn't an illness but...)
• Identifying someone affected by poison and potentially identifying the poison - how long ago it was administered etc.
• Knowledge of drugs like sedatives, hallucinogens, stimulants and intoxicants (if these exist in your game). Knowledge of a banging hangover cure!
• Know how to prevent diseases taking hold - granting advantage on saves against diseases caught from the environment with some prophylactic action.

Can I have some help over here! - First Aid
Using the help action you can stabilize a dying creature without a healer's kit. This is somewhat undermined by the fact that with a 50gp healer's kit you can do this without a Medicine check. Magical healing also seems to be fairly ubiquitous with Second Wind, Healing Word, and Healing surges. I think there are ways this could be expanded.

• With the use of a healer kit and a Medicine check allow the subject to spend 1 HD after a minute of resting instead of needing to spend an hour. There are plenty of times where a player might not have time to wait an hour but there would still be time to apply bandages and some anti-septic.
• With a successful medicine check and a use of a healer kit allow a PCs to roll twice and pick the best result when spending HD on a short rest to regain HP.
• When treating a poisoned or diseased individual. Allow them to use either the healer's Medicine check or their saving throw - whichever is better. Its probably worth limiting this to cnce per frequency of the check.
• Allow a character with medicine to treat up to their proficiency + Wisdom modifier characters per long rest and with a successful check allow them to regain all their HD instead of half.

This might sting a bit - How injured is someone?
The bloodied condition exists now in the game but it has very few interactions with the rules. Some DM's may reveal which creatures are bloodied and which aren't

• Allow a character with the proficiency in Medicine to tell whether a creature is bloodied or not.
• Allow a character with Medicine to make a check to tell how injured a creature is... The old Baldur's Gate system used to be great for this,
  • Uninjured - Full HP
  • Barely injured - 76-99% HP
  • Injured - 51%-75% HP
  • Badly injured - 26-50% HP
  • Near death - 25% HP or less
• You could make this harder the more unusual the anatomy of the creature is. Perhaps limit it to one creature per round or make it a bonus action or even an action.

Pharmacology 101 - Crafting
You can create healing potions using the Nature skill and use of a herbalism kit.

• At the risk of making Nature less useful, why not allow a character with Medicine to craft something similar using drugs bandages and antiseptics rather than rare plants. You could potentially require a character with Medicine to administer it.
• Allow someone with the skill to craft Anti-toxins using the same rules as healing potions.
• Add other drugs into the game and allow someone with Medicine to craft them.

Trust me I'm a doctor - Influencing
There is something unique about doctors and the calming influence they have over patients and even the general public. A little clinical knowledge is a powerful thing and skilled healers would often be respected and valued members of their communities. Going further than this some doctors were essential figures at court. Particularly when someone important or one of their relatives had a long term or debilitating condition.

• Allow a character with Medicine to use it with the Charisma to calm or influence and injured NPC
• Allow a character with Medicine advantage on Persuasion tests to influence an injured NPC they have treated or offered to treat.
• Allow a character with Medicine access to higher status characters or reclusive that otherwise wouldn't give adventurers the time of day.
• If you use Influence sub-systems allow a character with Medicine a chance to alleviate the conditions of an NPC with a long term illness of an important individual and their relatives.

Above all DMs. Give your characters with Medicine chance to use their skills. Let your campaigns and NPCs be filled with plague, rickets, halitosis, receding hairlines, stomach upsets and the flux.

What are your thoughts? What other sensible suggestions do you have to make Medicine at least mid table rather than rock bottom? Would these suggestions manage to do this if adopted?

 

[Distracted DM]

You covered some nice non combat uses here.

Medicine would be a lot more important if characters didn't automatically heal to full from a long rest. Imagine if you could use medicine to restore hit dice! Modern DnD characters are made so bounce-back and durable, but they can be low on hit dice after a few hard days. Since a long rest only restores half hit dice maybe that could be another "in" for medicine?

I recall some old DnD novels where the cleric still had to diagnose the injury before they could heal it.. maybe medicine could help make non combat healing more effective.

 

[aco175]

Using the healer's kit to stabilize someone with an action, I might let someone with Medicine use a bonus action instead since it is not something to get advantage with. Does not make sense timewise but little does in the game.

Using it to determine a monster that is bloodied is not something in my game. I figured that all the PCs would be aware of this.

 

[TheSword]

You covered some nice non combat uses here.

Medicine would be a lot more important if characters didn't automatically heal to full from a long rest. Imagine if you could use medicine to restore hit dice! Modern DnD characters are made so bounce-back and durable, but they can be low on hit dice after a few hard days. Since a long rest only restores half hit dice maybe that could be another "in" for medicine?

I recall some old DnD novels where the cleric still had to diagnose the injury before they could heal it.. maybe medicine could help make non combat healing more effective

I agree. In gritty health variants when HP come back less often it would be much more useful.

I do think the change to the restoration spells are a game changer. Not being able to magically cure disease is a big change. Of course only if disease is a thing in the game.

 

[TheSword]

Using the healer's kit to stabilize someone with an action, I might let someone with Medicine use a bonus action instead since it is not something to get advantage with. Does not make sense timewise but little does in the game.

Using it to determine a monster that is bloodied is not something in my game. I figured that all the PCs would be aware of this.

You could give more details than blooded…. But yes I do the same as you!

 

[mellored]

Suggestion.

When you or an ally expend hit dice durring a short rest, you can make a medicine check to attempt to aid their recovery. Roll a medicine check and get they following based on the result.
<5, you botched it. Roll the hit dice twice and take the lower result.
6-10, No effect
11-15. Roll the hit dice twice and take the highest result.
16-20. Maximum hit points regained.3

 

[TheSword]

Suggestion.

When you or an ally expend hit dice durring a short rest, you can make a medicine check to attempt to aid their recovery. Roll a medicine check and get they following based on the result.
<5, you botched it. Roll the hit dice twice and take the lower result.
6-10, No effect
11-15. Roll the hit dice twice and take the highest result.
16-20. Maximum hit points regained.3

I like it. Another option could be make a medicine check when someone spends HD to recover hp. If successful they spend one less HD. For every 5 points of success they save an additional HD.

 

[Tonguez]

Youve covered some nice options, unfortunately medicine is undermined by healing spells and easy rest options.

If spells were skill based Id require medicine skill to use cure spells. So maybe for a start allow a med check to stabilize to +1d6, scale up with level xd6?

Healing on a short rest with a med kit is nice too, curing status effects maybe?

 

[Seramus]

Imagine if you could Treat Wounds to refresh some HP every hour or so, maybe requiring 10 minutes of the doctor's time? Then you could throw in a feat about delivering emergency Battle Medicine someone could benefit from once a day or so, along with some kind of Doctor's Visitation where you can rush over to help an ally with medicine? Or even some kind of Ward Medic where you can treat multiple people at once during non-combat exploration time?

 

[el-remmen]

Allow a character with Medicine to make a check to tell how injured a creature is... The old Baldur's Gate system used to be great for this,

• Uninjured - Full HP
• Barely injured - 76-99% HP
• Injured - 51%-75% HP
• Badly injured - 26-50% HP
• Near death - 25% HP or less

My group has categories like this that they use to describe their HP loss to each other and that I use to signal how injured opponents are, but we used the cure spell categories as they existed in previous editions, "light, moderate, serious, and critical" and used "mortally wounded" to mean someone at 0 or below.