While this is true, realism isn't a big concern for RPG for me except for modern day rpg with gritty feeling. Everyone else, verosimilitude is more important than realism.I do believe there is a trade off for realism
A thing that surprised me in two games I read recently was allowing the player to decide when they are wounded. Song of Fire and Ice and Legend of Anglerre/Dresden Files both have this perk. Sound interesting