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D&D 5E How should 5E handle healing?

Which of the following statements should be true for Healing in 5E?

  • It takes days, if not weeks to regain hit points by resting.

    Votes: 34 33.7%
  • The Heal skill is very effective, but only out of combat.

    Votes: 52 51.5%
  • The Heal skill is effective, even in combat.

    Votes: 28 27.7%
  • Non-spellcasters can grant temporary hp, but not heal in combat.

    Votes: 29 28.7%
  • Divine spellcasters are the best at healing.

    Votes: 67 66.3%
  • No healing spells for arcane casters.

    Votes: 34 33.7%
  • Healer / leader / support classes can be of all flavors, not just divine.

    Votes: 64 63.4%
  • Classes can have self-healing powers, regardless of flavor.

    Votes: 37 36.6%
  • Each character has an ability similar to Second Wind.

    Votes: 59 58.4%
  • 5E should use Healing Surges or a similar mechanic.

    Votes: 38 37.6%
  • Healing potions and similar items should be easy to obtain.

    Votes: 31 30.7%
  • None of the above / special snowflake.

    Votes: 7 6.9%

  • Poll closed .


I think the most important element for me is that healing scales with base hit points.

It would also nice if all characters had some kind of ability to restore hit points (it makes solo games more viable), but it's not essential. It does not necessarily have to be "healing" either - having vigor points that are functionally equivalent to hit points and are quickly restored (say, with a short rest), used alongside actual hit points which are only restored through magic or days of rest would also be fine. You could even have both options, split up among thematic or class lines - martial characters and barbarians get vigor points, druids, divine and psionic characters get self healing (primal vigor, cure personal wounds, cell adjustment, etc.)

Everything else can be modular. I know what I like and what I don't like, but my tastes aren't universal, and it would be quite selfish of me to deny others options which they would want in their games just because I don't want them in mine.

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First Post
Some of the options are good, but I'd like to add a special snowflake: in combat healing is rare.


The more I think about it, the more convinced I become that combat needs to be balanced around the idea that no healing will happen until after the fight. That maximizes the ability of the DM to decide how he wants to handle things in his/her campaign.

If healing actions in combat had a hit point/action rate that approximated the damage/action rate of the players (or maybe the damage/action rate of the monsters?) then theoretically adding healing would not affect balance seriously.

true healing should be in the hands of divine casters or those who have access to the healing skill.

Healing spells should mainly take some time and mainly be used out of combat.

There shouldbe a second wind however and there should be plenty of options to trigger it. Also there should be quite a few possibilities to grant temporary hp.

Necromancy spells though arcane should be able to grant healing, but in a twisted and gloomy way. And a lot higher in level than divine healing. So I voted no arcane true healing spells.

Healing surges are not mandatory, but second wind and healing surges could be combined.
The character sheet should have 4 conditions on the HP bar: healthy, bloodied (1/2 hp), injured (1/4 hp), unconsciuos.
Spells can restore hp equal to bloodied or injured value.
Poison can only affect bloodied targets (you remain bloodied if you are healed by a non divine spell, even if your hp rise above that level again). Injured targets have a wound that needs healing after the combat.

Or something like this.


This is actually one of those areas that really needs a big section of options.

Personally, I've always conceptually liked the feel of healing that trades lethal damage for non-lethal damage, or for CON drain that recovers over weeks. Partly, that comes from the early chapters of The Eye of the World, which has some of the best displays of believable, but awesome, adventuring magic ever written in a novel.

For similar reasons, I'd love to see the "wizards can't heal" trope die in a fire. One of the things I loved about my 3e-era Midnight games was the way spellcasting worked. Often, the spellcaster had to choose between using their spell energy on battle and utility magic, and having it available for healing. It made for an interesting "balance." If the channelers went crazy with the combat spells, they might not have enough left to heal someone when the combat was over.

Clerics (and druids) have been given big-damage evocations along with their healing spells, granted powers, AND the ability to wear armor and fight effectively. So clearly, the lack of wizard healing isn't a "balance" issue. So is it just a "trope of D&D" thing?


First Post
I think that out-of-combat healing should be able to be done by any class, though different classes may do it in different ways. Rangers/Druids should be masters of herblore healing, while fighters/rogues/wizards/etc can always purchase healing potions. All classes should have an option to get healing skill that allows them to recover a few HPs after every battle, or help stabilize a dying character. Clerics should be the main guys to do in-battle curing; that's their niche.

A party can thus survive just fine without clerics. Out of battle, a cleric doesn't really heal any better than any other class, since the cleric still wants to preserve his finite magic supply for in-battle emergencies.

In-battle, a cleric's healing ability should not outstrip offensive techniques in terms of hps per turn. In other words, a cleric should not be able to heal allies for more HP/turn than other characters can dish out as damage/turn. However, a cleric's healing is still a valuable thing to have for those cases where the monsters get lucky and unexpectedly severely crit a PC, or the PCs make a mistake and allow someone to be isolated. In these cases, the cleric's in-battle-healing mitigates against a sort of D&D form of 'gambler's ruin'. His healing is rarely the most optimal choice in a battle, but when things go haywire, it suddenly becomes a wonderful thing to have.

Thus the cleric serves a useful role without becoming absolutely necessary for someone to bite the bullet and play the cleric even though nobody really wants to.


First Post
I don't really know what to vote here, but I poked some buttons anyway, based more on concept than actual agreement with the poll choice... This poll seems to make the assumption that hit points are your "health bar". I don't see it that way. I see it as just another defense, whether it be, luck, skill, or resilience.

D&D does not have a wounds system. And while I like wound systems, I'm not in favor of adding the complexity of a wound system to D&D as a core rule. Maybe it could be one of those optional rules. And with such a rule set, sure, wounds could take days to heal, require magic to heal faster, make healing skill more useful out of combat, and all that good stuff.


Steeliest of the dragons
This is curious...just to recap for those not paying attention...

Those responses that have over 30...that's over 50% of respondents think/want the following:

The Healing Skill is very effective, but only out of combat. (53.73% of respondants)

But believe...by far

Divine casters are the best at healing.

Far and away with nearly 75% of the responses.

AND think...

Healer / leader / support classes can be of all flavors, not just divine.


Each character has an ability similar to Second Wind. (almost exactly the equivalent to the percentage of people that want the Healing Skill to be very effective out of combat.)

Nice mash up of "old school" and "new school" tastes there.

If they follow that, I think everyone can be happy.


BIG WORDS at the start of the Hit Points section:

Hit points represent your vigor to avoid actual wounds.

When an attack deals hit point damage, if you still have HP afterward that attack only grazed you, or it caused pain that can be overcome. When an attack reduces your HP to 0, it knocks you down and leaves you unable to keep fighting. You're disabled until you either regain hit points or you die. While disabled, you can take no actions but you are aware of your surroundings.

You cannot have negative hit points. When you're out of HP, further damage becomes critical damage. If you have any critical damage, you're wounded. If you have critical damage greater than one-quarter your normal maximum HP, you're severely wounded. Once you take more damage than half your maximum HP, you die.

Getting Back on Your Feet
Various effects can let you can regain HP, up to your original maximum. Most often this represents you getting your second wind and rallying your strength, or an ally inspiring you to keep fighting. Sometimes these are spells that physically heal minor injuries or infuse you with vigor. Once you have any HP you are no longer disabled.

When you take a short rest (5 minutes) you regain all your HP. When you take an extended rest, reduce your critical damage to 0. However, this does not remove the wounded or severely wounded conditions. Those have to heal on their own.

When you are wounded, you take a -2 penalty to all d20 rolls and you grant combat advantage. While severely wounded, you take a -5 penalty to all d20 rolls, you grant combat advantage, and you can only take one action per turn.

If left to natural healing, make a DC xx {{Endurance/Constitution/whatever}} check each day to remove the wounded condition, or a DC yy check each week to remove the severely wounded condition.

The Heal skill can let an ally treat your wounds so you heal faster. Some magical effects can remove the wounded condition in just a few moments, or reduce the severely wounded condition to just wounded. The availability of magical healing depends on your setting. Classic D&D makes healing plentiful. Low Fantasy D&D requires long rituals to heal wounds. Grim D&D has no magical healing.

Optional Rule - No Wounds
Some gamers prefer simpler rules. You still die when your critical damage is equal to half your normal maximum HP, but you never become wounded.

Optional Rule - Gruesome Wounds
When a critical hit causes you to become wounded, make a save (DC xx). If you fail, you suffer a gruesome wound appropriate to the attack. These wounds should be something that won't end your adventuring career. You might lose a hand or an eye, but not a whole limb.

If the crit caused you to become severely wounded, the wound should be even more gruesome, of the sort that renders you almost incapable of adventuring unless you can receive magical healing.
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First Post
Good questions.

I have never had a problem with clerics healing during combat, but I have had a MASSIVE issue with clerics being obligated to give up spells during resting. I like that you had the option for the healing skill to be effective out of combat....Thats the ticket!

Edit : Im surprised by the number of people that voted for "It takes days, if not weeks to regain hit points by resting"...that what turns the cleric into a healbot and makes no-one want to play it.
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Jeff Carlsen

How healing works and how damage works are intrinsically tied. Before discussing either, we must first determine what we want the mechanics to represent.

I want characters who can be injured, and I want injuries to take a long time to heal, but I don't want characters getting injured in every combat.

I want a small amount of penalty to actions based on pain, fatigue, and injury, but I want it limited and easy to track. It should avoid the death spiral while still having a meaningful mechanical effect.

I want rage, inspiration, and fear for their children to temporarily grant characters the ability to fight well despite pain and injury, and to fight better when they're healthy.

I want divine magic (positive energy) , and only divine magic, to be able to quickly heal small cuts, burns, and bruises during combat. It should heal damage at a consistent rate that scales with level.

I also want divine magic to be able to accelerate recovery from more serious injuries, but only very powerful magic should have an injured character fully recovered in a day.

I want there to be a limitation to how much magical healing a body can take without side-effects, but I want that healing to be readily available in combat even without a cleric, preferably in the form of single use items such as potions.

The Mechanics

Here is an idea of how it could work. Keep in mind that the numbers chosen are meant to represent the idea, so consider them malleable. Playtesting would be required to hammer everything out.

Effects of Damage: I see there being two health related conditions, Bloodied and Wounded. Bloodied occurs when you're down half your hit points. Wounded occurs (by default), when you reach 0 hit points in addition to whatever the death and dying rules happen to be. Both impose a -2 Wound Penalty on the character, but wound penalties don't stack to prevent a death spiral. This incentivizes characters to never let each other drop to zero hit points.

Cure Spells:
The Cure spells heal hit points, and can remove the Bloodied condition, but they can never heal the wounded condition. Only long term healing can do that. Say, four weeks without strain to heal naturally, half that if you have magical help. Powerful rituals or spells might cut it down further.

Each cure spell simply heals a percentage of your total HP, such as:

Cure Light Wounds: 25%
Cure Moderate Wounds: 50%
Cure Serious Wounds: 75%
Cure Critical Wounds: 100%

Limited Healing: If a character receives a total amount of healing in a single day that is more than 100% of his or her total hit points, they are sickened for the rest of that day. Penalties from being sickened do stack with the bloodied or wounded conditions. Thus, you can heal characters as much as you want, but there is a consequence.

Adrenaline Surge: Some conditions, such as Barbarian Rage, bardic music, an invigorating speech, or even a dramatically appropriate sense of desperation, cause a surge of adrenaline that allows a character to ignore pain and injury and fight with great conviction. How long this lasts depends on what triggered it, but the effects are the same. The character ignores all wound penalties and receives a +2 to all attacks. They also gain temporary hit points equal to 50% of their total.

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