D&D 5E (2024) Healing Isn’t What You Think: The Value Curve Across a Fight

[Koloth]

I've never understood the concept that you shouldn't heal in combat. Depending on the combat of course. Every game I've DMed or played in has had the healer and other characters keeping each other alive. It's always been a vital part of all but the easiest of encounters. Are DMs just not dealing enough damage or running easy combats?

I think it is less no healing during combat and more "What is more effective for the healer to do?" Most healers are also capable of dishing out a fair amount of damage targeted at the opposition. Each time the healer gets a chance to act, said healer has a decision to make, heal someone or damage someone? In a recent PF1 game, I was the party's primary healer as an Oracle. But I also had some rather potent AOE damage spells. Cast the AOE spell and blast the opponents or heal someone(s)? Get it wrong and things can go bad for the party in short order.

 

[AlexofBarbaria]

The classic healer role is supposed to be catastrophe prevention: your job is to smooth out the party health bars to prevent someone from dying, even though this sacrifices optimal attrition rate. In 5e the dying mechanics are very soft and already protect PCs from catastrophe, so the healer role is much simpler. You don't have to monitor everyone's HPs and decide when it's worth it to trade DPR for healing; you just heal when someone drops, or when you have nothing else to do with your bonus action.

Given how carefully 5e was designed and how strongly simplicity was emphasized I think this is probably by design, not a side effect. I suspect they thought it was clunky/tedious to keep an eye on everyone's HP and it was good for healing to have an obvious trigger. But I could be wrong. It's very hard to believe they didn't notice whack-a-mole happening in playtesting though.

 

[Tessarael]

These are some of the healing spells that may make the most sense to use in combat:

• Aid: Level 2, action, increase 3 creatures current/max HP by +5 for 8 hours. +5 HP per higher spell slot level.
  • Cast this outside of combat, as it is an 8 hour buff.
• Cure Wounds: Level 1, action, heals 2d8 + spell casting ability modifier. +2d8 per higher spell slot level.
• Heal: Level 6, action, heals 70 HP. Ends blinded, deafened, and poisoned conditions on target. +10 HP per high spell slot level.
• Healing Spirit: Level 2, bonus action, heals d6 to creatures that enter the 5' cube, up to 1 + spell casting ability modifier times. Healing increases +d6 per higher spell slot level. Scales very well: 6d6 total healing as level 2 spell with Wisdom 20; 12d6 total healing as level 3 spell with Wisdom 20, etc.
• Healing Word: Level 1, bonus action, heals 2d4 + spell casting ability modifier. +2d4 per higher spell slot level.
• Heroism: Level 1, action, gives temporary HP equal to your spell casting ability modifier, and immunity to fear. +1 target per higher spell slot level.
• Mass Cure Wounds: Level 5, action, heals 6 creatures 5d8 + spell casting ability modifier. +d8 per higher spell slot level.
• Mass Heal: Level 9, action, 700 HP of healing divided as you choose across targets within 60'. Ends blinded, deafened, and poisoned conditions on those healed.

Note: I have not listed spells like Aura of Vitality, which are suboptimal vs. the options listed above.

 

[Zardnaar]

I've never understood the concept that you shouldn't heal in combat. Depending on the combat of course. Every game I've DMed or played in has had the healer and other characters keeping each other alive. It's always been a vital part of all but the easiest of encounters. Are DMs just not dealing enough damage or running easy combats?

Opportunity cost.

Healing generally doesnt keep up with damage. Killing stuff faster or disabling them will reduce incoming damage.

A gladiator for example (CR5) 3 attacks for 2d8+4 damage each. RAW can turn up at level 3.

A level 2 cure heals 4d8+3 or 4. Gladiator rolls well he's outpacing your healing.

A hold person spell has an excellent chance of removing the gladiator from the game.

 

[500 Toads]

...and that's with Cure Wounds having been significantly buffed in the 2024 revision, doubling the number of d8s and losing the prohibition on undead and constructs. Same for Healing Word doubling its d4s and losing those restrictions.

 

[Cap'n Kobold]

I've never understood the concept that you shouldn't heal in combat. Depending on the combat of course. Every game I've DMed or played in has had the healer and other characters keeping each other alive. It's always been a vital part of all but the easiest of encounters. Are DMs just not dealing enough damage or running easy combats?

Quite the opposite.
If one of the party can afford to spend their action healing someone who isn't in immediate need, rather than trying to remove the source of damage in the first place, the fight is probably going in the party's favour already.

 

[Cap'n Kobold]

The Healing Value Curve
Whack‑a‑Mole is just the poster child

Most people talk about healing as if its value is constant - “healing is good,” “healing is bad,” “healing is only for downed allies,” etc.

But healing doesn’t have a fixed value. Healing has a curve.

Early in an encounter, when enemy threat is high, healing rarely negates full enemy turns. Later in the encounter, when fewer enemies remain, healing can actually outpace incoming damage - but by then the risk of not healing is low unless someone is downed.

The incentives built into 5E push healing toward the later moments of a fight, or even better, after the fight altogether.

A typical encounter may look something like this:

Round	Enemies	DPR	Cure Wounds
1	4	52	13
2	3	39	13
3	2	26	13
4	1	13	13

Two insights fall out of this immediately:

1. Early healing doesn’t keep up with enemy output.​

If you heal early, enemies stay alive longer, which means:

• more total attacks
• more total incoming damage
• more healing required overall

You’re spending actions to slightly delay the inevitable instead of changing the board.

2. Healing gets stronger as enemy count drops.​

By round 3 or 4, healing can actually exceed incoming DPR - but at that point:

• the fight is nearly won
• the risk of a down is low

The best time to heal is often when the fight is already under control.

Delayed Healing vs Whack‑a‑Mole​

Because healing’s value increases as enemy count decreases, 5E naturally incentivizes delayed healing. Whack‑a‑mole healing (healing someone only when they drop) is just the clearest signal of this incentive.

Whack‑a‑mole isn’t a meme, it’s a symptom of the underlying math.

Why this Matters​

Once you understand the healing curve, it becomes much easier to talk about:

• when healing is wasted
• when healing stabilizes the fight
• when healing wins the fight
• why healing early is almost always low value
• action economy
• enemy turn prevention
• marginal value
• timing windows
• deeper decision‑making framework behind optimized play

I intend this thread to serve as an entry point into those kinds of conversations.

Generally I find that combat healing on an active character is used when a party member is under threat, monsters rolling well, focus fire etc. When Cure Wounds is being used, it is often upcast if it can be rather than being cast at just the base level.

 

[Silam]

It’s all a matter of risk management.

As was mentioned previously, 1 HP is max power, while 0 HP is zero power.

The big issue is initiative order. If you ever have monsters going after the healer but before an ally, then there is a chance (however small) that they down the ally and flush that person’s actions down the toilet.

Healing is insurance. There’s an opportunity cost, for sure. Maybe the Cleric’s actions are quite effective, but is it a net positive if the Cleric gets to do their thing, the ally loses their action, and then the Cleric still needs to spend the healing resource later anyway?

Another big part of the calculus is: how many healers do you actually have and how effective are they? If only one party member has Healing Word, and everyone else has potions or goodberries, that’s one thing. If two party members have Healing Word, that’s a very different thing.

Nothing worst than losing your main healer and having the Fighter need to disengage, walk halfway across the battlefield and make the healer gulp down a potion. Now THAT’s a lot of wasted actions.

And what if you’re in a fight where there are lots of sources of ongoing damages? Getting downed might mean you have several failed death saves coming your way fast. No big deal, you can Revivify, right? But it’s a bigger cost than a simple healing. And a potion won’t cut it.

So, overall, I think the OP has relevant insights, but there are lots of variables that muddy the analysis. As usual, it is very table dependant. The party composition and the DM’s playstyle will have a big impact.

 

[CreamCloud0]

I think this is a double sided issue, either monsters aren’t dealing enough damage that just killing them is more effective than healing your teammates or they are dealing enough damage and you get complaints that nobody wants to have to be forced into being the party’s medic.

 

[Zardnaar]

I think this is a double sided issue, either monsters aren’t dealing enough damage that just killing them is more effective than healing your teammates or they are dealing enough damage and you get complaints that nobody wants to have to be forced into being the party’s medic.

Its even hard to kill them fast.

Control and beat them up is best approach.

You dont want to be trading damage.