D&D 5E House rule for in combat healing and yoyo at 0 HP

[Cap'n Kobold]

The problem is that a game where healing is good universally ends up with either rocket-tag, or non-threatening combat.

No, I think that there is a middle ground between rocket tag and non-threatening combat, rather than just those two extreme positions.
The suggestions already mentioned of adding Temp HP, or allowing the recipient to spend some of their hit dice fall into that middle ground.

The discussion is about moving pre 0HP healing from "almost always a waste" to "a viable option to spend resources on", and so prevent the "whack-a-mole"/"yoyo" issue.
No-one is talking about trying to sustainably negate all of the damage the party is taking from a level-appropriate encounter.

Rocket tag is when the only way to kill a PC is to take them out before healing can land. You can see this in a pile of games.

Non-threatening combat is when damage does nothing but drain the tank of the healer. Taking damage isn't a threat, it is just a resource drain on the healer. When the healer runs out of oomph, the day ends.

Both of these where true in 3e. Healing could outpace damage, healers had far more healing resources than warrior types had HP, and a real threat either wiped a target's HP out in one blow or bypassed HP entirely.

4e moved a huge amount of a healer's power budget to the target PC. Running out of HP was a single-encounter thing mostly, and the daily resource drain was on daily powers and healing surges.

5e, at least initially, moved to a model where running out of HP and HD is a daily resource drain. A melee type can contribute more HP than a healer can over an adventuring day, and the use of healing was more of an emergency thing than anything. Spell slots where better used in ways besides healing.

The issue is that in most cases, healing someone before they go down doesn't work as an "emergency thing". Burning an action and a high-end resource on healing often won't give a fellow party member more survivability, until after they are on the ground.


Currently in-combat healing is most effective when applied to someone who has already gone down. We're looking into ways of making healing useful before that happens, so DMs don't feel the need to push the players towards a 5MWD, by attacking characters that are bleeding out or introducing mechanics that punish dropping to 0HP without addressing the systemic issue.

 

[FrogReaver]

The problem is that a game where healing is good universally ends up with either rocket-tag, or non-threatening combat.

Rocket tag is when the only way to kill a PC is to take them out before healing can land. You can see this in a pile of games.

Non-threatening combat is when damage does nothing but drain the tank of the healer. Taking damage isn't a threat, it is just a resource drain on the healer. When the healer runs out of oomph, the day ends.

It also tends to make a healer mandatory, which is something i'm glad D&D is moving away from.

Both of these where true in 3e. Healing could outpace damage, healers had far more healing resources than warrior types had HP, and a real threat either wiped a target's HP out in one blow or bypassed HP entirely.

To be fair - healers in 5e tend to be able to heal more than warriors have hp+hit dice. Maybe not by as large of a margin.

What I see in this thread is people seeming to ask for 3e style healing, what I consider the most boring era of D&D heal-wise; healing that makes non-fatal damage trivial.

I think there's a large gap between wanting 3e style healing and wanting 5e healing to be a bit more potent. I think some haven't really worked out the details and that 5e healing doesn't really have much room to improve before healing outpaces an appropriate amount of damage.

The problem I have is that it isn't a huge gap between "healing isn't worth doing in combat" to "healing makes damage trivial". The life cleric in 5e almost bridges that gap.

If the Life Cleric could heal above half with it's channel divinity, that would be too much healing. On the flip side, only being able to heal to half hp certainly incentivizes whack a mole, even with the channel divinity - because it means you want allies really low on hp to get the full impact of your ability.

It's almost like all the design decisions around healing and death center around having an ally drop to 0 and then get brought back to consciousness with healing. Which is a solution that threaded the needle between some of the largest issues at the time of 5e's creation. Healing that is impactful but not mandatory vs healing that trivializes enemy damage until it's out. It's just the chosen solution introduced its own set of problems.

I don't think there's a design decision around healing that' perfect or going to please most everyone. I think 5e gets close though, but want to see some design around deincentivizing whack a mole.

 

[NotAYakk]

No, I think that there is a middle ground between rocket tag and non-threatening combat, rather than just those two extreme positions.
The suggestions already mentioned of adding Temp HP, or allowing the recipient to spend some of their hit dice fall into that middle ground.

One suggestion was doubling healing via Temp HP. That is enough that a party of clerics would be able to stop almost all incoming damage against a level appropriate encounter until they ran out of spell slots.

The ratio between "doesn't help against damage" and "overwhelms damage" is very narrow.

In 4e, the deal was that you got a very limited number (per encounter) of reasonably large heals (35%-50% of target's HP) that consumed the target's resources (healing surges), plus a very limited number (per day) of target-resource-free heals, and a robust expectation of many encounters per day.

The issue is that in most cases, healing someone before they go down doesn't work as an "emergency thing". Burning an action and a high-end resource on healing often won't give a fellow party member more survivability, until after they are on the ground.

Well, that depends. Are you dropping the heal on someone at 10% of max HP, or are you panicing at 50% of max HP? Is the target also panicing, burning their action to dodge? Was this panic triggered by a dogpile that can be avoided next turn, or a lucky crit by the foe?

If ongoing damage is enough to trigger 'they are about to go down next turn' from full HP in 1-2 turns, and the situation doesn't change, then healing won't be enough. They'll still drop in 1-2 turns even if you blast the target with healing (exceptions: PW:Heal, Mass Heal, Heal spell).

Currently in-combat healing is most effective when applied to someone who has already gone down.

Except, the game mechanics make in-combat healing nearly useless against someone at 0 HP. Because someone at 0 HP is almost certainly dead before you can land a heal.

Unless, of course, you have a DM that makes super-high-damage encounters and pulls punches once targets are at 0 HP. Which seems really common. And making 0 HP punish more when literally by fiat the DM is not punishing 0 HP like the game provides seems strange to me.

 

[Clint_L]

Except, the game mechanics make in-combat healing nearly useless against someone at 0 HP. Because someone at 0 HP is almost certainly dead before you can land a heal.

Not even remotely close to accurate.

Also, I strongly challenge the implication that the logical thing for creatures to do is to keep attacking a fallen opponent. Rounds are supposed to be 6 seconds long, with everything happening almost at once. If I am in a fight for my life with the PCs, I am not going to keep attacking a downed opponent in the middle of the ongoing battle. Not unless I have no better target, and I have good reason to believe that they might be about to receive a magical heal, which in my world is not a normal thing.

 

[FrogReaver]

One suggestion was doubling healing via Temp HP. That is enough that a party of clerics would be able to stop almost all incoming damage against a level appropriate encounter until they ran out of spell slots.

This feels more like moving the goal posts. We started out at a single cleric, now we are at a whole party of clerics.

Besides, I think a party of clerics should be able to do just that. Heck they probably can currently - they will just run out of spell slots quite a bit faster.

The ratio between "doesn't help against damage" and "overwhelms damage" is very narrow.

I'd love if any cleric could use his highest level slot on highest level heal spell and on average heal enough that 99% of level appropriate non-solo enemies won't down the PC again next round even if they hit (at least +75% of the time). Caveat, all bets are off if PC is being focus fired.

I think that falls into that narrow sweet spot and is still probably twice as much healing as 5e currently provides.

Except, the game mechanics make in-combat healing nearly useless against someone at 0 HP. Because someone at 0 HP is almost certainly dead before you can land a heal.

So let's do some math. Enemies need at least 3 melee attacks against a 1 hp PC to kill him. 1 to down him, the first to cause 2 death saves, and the last to cause the final death save. Realistically they need 4-5 to do it reliably since it's unlikely 3/3 attacks hit even when some are at advantage.

Now let's look at ranged attacks. Need 4 to hit, however all after the first one will be at disadvantage because the PC falls prone. Meaning realistically you need like 10+ ranged attacks to reliably kill a 1hp PC before he's healed.

In short, it's not nearly as easy as it seems to kill a PC before he gets healed.

Unless, of course, you have a DM that makes super-high-damage encounters and pulls punches once targets are at 0 HP. Which seems really common. And making 0 HP punish more when literally by fiat the DM is not punishing 0 HP like the game provides seems strange to me.

This is very common - but it's probably at least in part because it takes so much of team enemy action economy to actually kill even a 1 hp PC.

 

[NotAYakk]

Not even remotely close to accurate.

Also, I strongly challenge the implication that the logical thing for creatures to do is to keep attacking a fallen opponent. Rounds are supposed to be 6 seconds long, with everything happening almost at once. If I am in a fight for my life with the PCs, I am not going to keep attacking a downed opponent in the middle of the ongoing battle. Not unless I have no better target, and I have good reason to believe that they might be about to receive a magical heal, which in my world is not a normal thing.

Sure, like I said, you as a DM can make 0 HP have next to no consequences. Which makes yo-yo healing optimal.

This is your choice, as a DM, to not use the already existing in black and white mechanics in the game to make 0 HP a really, really bad idea for PCs to hit.

It remains amusing that a DM who has decided to make 0 HP have no consequences then goes "I hate how PCs hitting 0 HP has no consequences and heals at 0 HP are super-good, how can I give it consequences?"

In fact, it seems to me that what is actually going on is that they don't like how harsh the consequences are of hitting 0 HP, and want something between what the actual rules give as consequences and what they are currently dealing out.

And yes, as the world the DM creates is completely and utterly within the control of the DM, I include whatever in-world rationalizations the DM does for why the DM doesn't impose the already existing in-game consequences for 0 HP on PCs to be a decision taken by the DM that removes said consequences. "My guy" syndrome applies to DMs as well; it is you, the DM, making a decision.

"I don't like how my world's assumption that magical healing is nearly completely unexpected makes my monsters assume 0 HP PCs are dead (or at least eliminated from combat), hence making magical healing on 0 HP PCs more effective than I like; I want to validate the assumptions of my monsters and make 0 HP PCs be more out of combat than healing magic rules imply, but not too harsh like 'magical healing on 0 HP targets only stabalizes them', or 'magical healing doesn't work on 0 HP targets'. Instead, something like 'the creature gains a level of exhaustion' or 'the creature is slowed for 24 hours', something that punishes without real danger."

I doubt this actually reflects anyone's full position - it is intentionally more than a bit of a straw man, so don't take it as putting words in your mouth - but this is what it looks like, and why it is amusing to me.

...

One idea I have played with is making being hit while down less harsh. This makes attacking downed targets less of a "DM is mean" and makes it more expected.

When a creature takes damage while at 0 HP, instead of an automatic failed death saving throw they make a death saving throw. On 1, they get 2 failures; on a failure, they get 1, and on a success they don't work towards being stable (but they don't interrupt becoming stable). On a 20+ they would regain 1 HP (be shocked awake by the damage), just for the drama of it.

Critial hits cause 2 death saving throws (instead of failures).

The goal here being that landing coup blows becomes a standard thing for foes to do.

You could push it a bit harder and not tell the other players how many failures have accumulated, or even not tell the PC (but the last one is cruel and removes dice rolling from an already downed PC). That makes not healing them far riskier.

By softening the harshness of "coup" attacks, we make making them more standard without being a "mean DM". And if you imagine that most NPCs/monsters have a penalty to death saving throws, doing a finishing blow againts non-heroic targets makes sense (it forces 2 checks, and within 6 seconds the creature is probably bled out on the 3rd check).

 

[FrogReaver]

Sure, like I said, you as a DM can make 0 HP have next to no consequences. Which makes yo-yo healing optimal.

This is your choice, as a DM, to not use the already existing in black and white mechanics in the game to make 0 HP a really, really bad idea for PCs to hit.

It remains amusing that a DM who has decided to make 0 HP have no consequences then goes "I hate how PCs hitting 0 HP has no consequences and heals at 0 HP are super-good, how can I give it consequences?"

In fact, it seems to me that what is actually going on is that they don't like how harsh the consequences are of hitting 0 HP, and want something between what the actual rules give as consequences and what they are currently dealing out.

And yes, as the world the DM creates is completely and utterly within the control of the DM, I include whatever in-world rationalizations the DM does for why the DM doesn't impose the already existing in-game consequences for 0 HP on PCs to be a decision taken by the DM that removes said consequences. "My guy" syndrome applies to DMs as well; it is you, the DM, making a decision.

"I don't like how my world's assumption that magical healing is nearly completely unexpected makes my monsters assume 0 HP PCs are dead (or at least eliminated from combat), hence making magical healing on 0 HP PCs more effective than I like; I want to validate the assumptions of my monsters and make 0 HP PCs be more out of combat than healing magic rules imply, but not too harsh like 'magical healing on 0 HP targets only stabalizes them', or 'magical healing doesn't work on 0 HP targets'. Instead, something like 'the creature gains a level of exhaustion' or 'the creature is slowed for 24 hours', something that punishes without real danger."

I doubt this actually reflects anyone's full position - it is intentionally more than a bit of a straw man, so don't take it as putting words in your mouth - but this is what it looks like, and why it is amusing to me.

...

One idea I have played with is making being hit while down less harsh. This makes attacking downed targets less of a "DM is mean" and makes it more expected.

When a creature takes damage while at 0 HP, instead of an automatic failed death saving throw they make a death saving throw. On 1, they get 2 failures; on a failure, they get 1, and on a success they don't work towards being stable (but they don't interrupt becoming stable). On a 20+ they would regain 1 HP (be shocked awake by the damage), just for the drama of it.

Critial hits cause 2 death saving throws (instead of failures).

The goal here being that landing coup blows becomes a standard thing for foes to do.

You could push it a bit harder and not tell the other players how many failures have accumulated, or even not tell the PC (but the last one is cruel and removes dice rolling from an already downed PC). That makes not healing them far riskier.

By softening the harshness of "coup" attacks, we make making them more standard without being a "mean DM". And if you imagine that most NPCs/monsters have a penalty to death saving throws, doing a finishing blow againts non-heroic targets makes sense (it forces 2 checks, and within 6 seconds the creature is probably bled out on the 3rd check).

I’d suggest that any mechanic that makes your Pc helpless and then your PC dies while being helpless is very unfun. So it’s no wonder DMs intuitively steer away from such mechanics.

 

[Cap'n Kobold]

One suggestion was doubling healing via Temp HP. That is enough that a party of clerics would be able to stop almost all incoming damage against a level appropriate encounter until they ran out of spell slots.

So?
They're burning all their actions and resources on not dying? That isn't going to win a fight, that is just losing slower. In order to win a fight, you need to spend those actions and resources on actually winning. (Achieving objectives, defeating opponents etc.)
That is the beauty of the temp HP idea: since temp HP doesn't stack, there is an inherent encouragement to do things other than heal. If they are taking so much damage that other party members are using their actions and burning resources just to stop them going down, then either they are either getting focused by all the opponents, took a chain of crits, or are holding the line against a superior foe - in which case it is just good party play to try to stop them from dying.

Well, that depends. Are you dropping the heal on someone at 10% of max HP, or are you panicing at 50% of max HP? Is the target also panicing, burning their action to dodge? Was this panic triggered by a dogpile that can be avoided next turn, or a lucky crit by the foe?

If ongoing damage is enough to trigger 'they are about to go down next turn' from full HP in 1-2 turns, and the situation doesn't change, then healing won't be enough. They'll still drop in 1-2 turns even if you blast the target with healing (exceptions: PW:Heal, Mass Heal, Heal spell).

There often isn't a massive amount that a player can do to avoid significant damage, outside of burning the same resources that heals also use. Dodging and avoiding melee often lead to other party members taking the hits for you.

Ideally, what we're asking healing to mean is that you are spending your turn, and a resource, to give another player another turn or more of actions for them to use.
That does not seem such a bad option for party play does it.

Except, the game mechanics make in-combat healing nearly useless against someone at 0 HP. Because someone at 0 HP is almost certainly dead before you can land a heal.

Unless, of course, you have a DM that makes super-high-damage encounters and pulls punches once targets are at 0 HP. Which seems really common. And making 0 HP punish more when literally by fiat the DM is not punishing 0 HP like the game provides seems strange to me.

I think that this is what you and many others of the "Kick the player when they're down" opinion are not getting: We do not like that optimal healing is performed at 0HP. We think that the mechanics rewarding that playstyle encourage degenerate gameplay. We would like the mechanics to encourage using healing while the character is still up. We would like character concept of someone who can support the party by healing to be a viable option.

Punishing the player for their character dropping down, whether through hitting their character whilst they are bleeding out, or death-spiral-inducing conditions inflicted on players who do drop to 0HP isn't a useful attitude unless you give the players more options to prevent their characters dropping to 0HP in the first place. Healing is one of those options.

 

[CapnZapp]

As a DM for my group I have found that I dislike that my players (understandably) let their characters drop to 0 before doing any healing which causes the yoyo effect.

Or the whack-a-mole effect. The monsters try keeping down the PCs, but they can't do it!

Our solution (that our DM didn't come up with himself):

You gain a level of exhaustion each time you drop to 0 hp. Each level of exhaustion gives a -1 penalty (cumulative) to every attack roll, saving throw and ability check . And only that, the PHB nonsense is replaced entirely. You regain a single level of exhaustion per long rest.

This quite effectively solves the problem. No player ever wants to "wait" until they reach 0 hp any more.

 

[GMMichael]

. . . In order to win a fight, you need to spend those actions and resources on actually winning. (Achieving objectives, defeating opponents etc.)

It also helps if you have more skill, allies, or planning than your opponents. But that goes beyond this thread's considerations...

There often isn't a massive amount that a player can do to avoid significant damage, outside of burning the same resources that heals also use. Dodging and avoiding melee often lead to other party members taking the hits for you.

Avoiding damage? What about Dodge, Disengage, Dash, and Ready actions? Other party members can take some damage too - that's why they wore armor.

Ideally, what we're asking healing to mean is that you are spending your turn, and a resource, to give another player another turn or more of actions for them to use.

I don't know. I always thought "you don't die today" was a good outcome of healing.

Punishing the player for their character dropping down, whether through hitting their character whilst they are bleeding out, or death-spiral-inducing conditions inflicted on players who do drop to 0HP isn't a useful attitude unless you give the players more options to prevent their characters dropping to 0HP in the first place. Healing is one of those options.

Is there honestly a shortage of these options?