D&D (2024) The Problem with Healing Powercreep

[Lanefan]

I know, and I agree with you that "press on or rest" is (or should be) an interesting decision point for players. I don't think it follows that "therefore resting should take days of game time and rather a lot of play time committed to busywork." The game logic alone applies narrowly to a specific kind of military scenario--one in which there are clear advantages to sustaining pressure on an enemy that wants to buy time.

In other words, an adventure on a clock. With those, it's easy to force the press-on-or-rest choice; but putting every adventure on a clock gets tiresome fast for all involved.

The game logic doesn't apply particularly well to other kinds of military scenarios. What if the pressure of an invader has united the enemy, and relaxing that pressure will cause them to fall back to infighting?

That still counts as the enemy "doing something". The PCs might not realize it (and it would admittedly be boring for the players) but sometimes their best in-game course of action might be to to Do Nothing for a while, let the enemy defeat itself, then roll in and mop up what's left.

What if there is no common, united "enemy" at all?

IME that's fairly rare at the per-adventure level; and missions without an enemy usually involve some sort of specific task that needs doing under a time crunch of some sort e.g. "get this book to Waterdown ASAP" or "find our missing livestock before the rains come".

On the campaign level, sure - a true sandbox campaign might not have a common "enemy" - but that's different; and see below.

What if the enemy is so big and the problem on such a scale that the party can remain in Rivendell as long as it takes? All the clerical BS is just delaying the cool Council scene that's coming next.

Staying in Rivendell as long as they did gave Sauron time to build his forces and further cement some alliances. That said, the fellowship had to wait for some of its members to arrive; so the net benefit was probably to the PCs in that case.

What if it's an exploratory expedition such as a hexcrawl, where pressing on into the unknown with insufficient resources is simply foolish?

I don't want to deny them the chance to do that foolish thing, if it's what they'd otherwise do.

What if it's a pulp Sword & Sorcery adventure where the pacing between Act I, Act II and Act III should be fast and furious? What if the PCs would otherwise press on to the next level of the dungeon, but because they know they have days of recovery and clericry ahead of them, they choose to withdraw early and get it over with before delving deeper?

I don't mind letting the players/PCs set the pace most of the time; and rarely if ever try to push that Sword & Sorcery pacing model. If they want to rest, that's fine...but there may or may not be consequences of so doing.

Now, what ties all of this together? Simple. All of the above elements cause more time to pass in the game world.

Nothing annoys me more from a believability standpoint than adventurers who go from 1st level to 15th+ in just two or three in-game months of hard-core adventuring. And yet, the recent WotC editions (4e in particular) support and encourage exactly this: that you'll blast through a typical adventure in an in-game day or two, gain a level or two, and take little or no downtime before diving straight in to the next adventure.

The only way a DM can make some time pass is by placing the adventure sites far enough apart that travel time becomes a significant factor. At the design level they've taken out forced downtime for level-up training and shunted aside or designed away most other downtime activities (stronghold building, magic item creation and-or buying-selling, spell research, even simple carousing - people had to push for the inclusion of any of these and some are still missing), leaving a default that, from a believability standpoint, is somewhat ridiculous.

Anyway, so as not to be a complete thread derail, Shadowdark still feels old-school to me and still gives the DM a terrific, much more flexible toolbox with which to present that "press on or rest" decision point while still using 5e's "full heal on rest" rules. In 5e itself, IME and as I said upthread, attrition pressures scarce resources (daily uses and spell slots) long before it pressures hit points, so even if you value the attrition dynamic, buffed healing spells shouldn't be a big concern. It might enhance the game effects of attrition by blowing through spell slots more quickly!

I guess the disconnect here is that the way I see it, both for PCs and monsters hit points should themselves be a much more precious resource than 4e-5e would have them be; i.e. fewer in number and harder to recover once lost.

As 5e has it now, the only hit point that really matters is the last one you have, and thus that's the only one anybody cares about curing. I'd like to see a system where they all matter - where losing any hit points is a small problem and losing a lot is a big problem - but then the cries of "Oh noes, it's a death spiral, what will we do?!" arise and the idea gets shot down.

Ideally, losing hit points should lead to a death spiral; in that the more you lose the worse off (mechanically) you should become. This would make it more important to heal up hit points as they are lost, rather than waiting until someone drops on reaching 0.

 

[Lanefan]

@Daztur I'm late to this thread, but let me tell you, I share some of your concerns, but not your conclusion. I worry about the hit point inflation that has been trending since the 2e to 3e switch. But, honestly, the buff of healing is about one of the few things I found enticing from 5.2.

Let me tell you, I know it isn't for everybody, but being a dedicated healer can be very rewarding. I could easily prepare all heals and not feel I'm missing out. I loathe having to spend my actions on "the real fun", and I would feel proud of ending a day with my party at or near full HP.

Fully with you this far. I also sometimes like playing the healer.

And I find 5e the least fun edition to be a healer. It is just too hostile to healers, and part of it is that in-combat healing is not enough to offset monster damage and thus not viable to do proactively. Add that to the existence of ranged and bonus action healing taking away the heal a fallen comrade mini-game, and out of combat and long term it is just gone. (Plus with monster HP being so high now there's too much peer pressure to do damage every turn) So what is left? Sneeze a few times a combat while you do your "real contribution" to the party? At least with higher healing proactive casting of cure wounds can be a thing again. Hopefully.

Where we differ is that I don't think in-combat healing spells should be do-able without significant risk to the caster. Buff before combat, heal after combat, and either contribute in other ways during combat or take the risk and drag the wounded out to heal them on the fly.

Part of this comes from my hill-I'll-die-on stances that a) spells should never be castable (other than by sheer luck) while a melee opponent can reach the caster and b) there should be no such thing as "ranged healing". You wanna cure that wobbling front-line Fighter who is still holding off two oppnents? Then you gotta put your butt on the line and hope you can a) get the spell away and then b) touch the target (touch AC was such a brilliant idea from 3e!) while she's busy dodging and weaving and defending against her foes.

Spells like Invisibility and Sanctuary (if it still exists) can help here; if the foes don't know you're there it's easier to get your touch-range cures away.

 

[Crimson Longinus]

In any case, I'm not sure I like how in 5.5 the power of some common healing spells are almost doubled. How do people think this will affect things? I get that combat healing was often ineffective, but this seems like a lot. One houserule I was considering at one point, was that instead of doubling the dice like 5.5 did, some healing spells would let the PCs to burn hit dice for additional healing (one die per spell slot level.) This would achieve similar effect of increasing the spell potency, but would limit how much one person could benefit from it.

 

[Micah Sweet]

Fully with you this far. I also sometimes like playing the healer.

Where we differ is that I don't think in-combat healing spells should be do-able without significant risk to the caster. Buff before combat, heal after combat, and either contribute in other ways during combat or take the risk and drag the wounded out to heal them on the fly.

Part of this comes from my hill-I'll-die-on stances that a) spells should never be castable (other than by sheer luck) while a melee opponent can reach the caster and b) there should be no such thing as "ranged healing". You wanna cure that wobbling front-line Fighter who is still holding off two oppnents? Then you gotta put your butt on the line and hope you can a) get the spell away and then b) touch the target (touch AC was such a brilliant idea from 3e!) while she's busy dodging and weaving and defending against her foes.

Spells like Invisibility and Sanctuary (if it still exists) can help here; if the foes don't know you're there it's easier to get your touch-range cures away.

I really think the issue here is a mismatch of priorities. Some of us want something resembling the actual experience and challenge of battlefield healing, and some of us want to minimize the time a player spends "out of action" during combat.

 

[Stormonu]

Healing spells in 5E did less healing than damaging spells. They didn't even match the DMG spell creation guidelines, and damage spells often did more damage than those guidelines. Healing has to be more than damage to make it worth doing over just killing the enemy faster.

Good, nothing is more frustrating that pounding on a bad guy to see them healing faster than you can dish it out - same for the reverse for the DM. Attritition should exceed healing so fights don't last forever.

Save the healing for after one side emerges victorious. In combat healing should, at best, give you an extra round or so at the most to soak damage from an unexpected crit or otherwise bad turn of dice rolls.

 

[Micah Sweet]

Good, nothing is more frustrating that pounding on a bad guy to see them healing faster than you can dish it out - same for the reverse for the DM. Attritition should exceed healing so fights don't last forever.

Save the healing for after one side emerges victorious. In combat healing should, at best, give you an extra round or so at the most to soak damage from an unexpected crit or otherwise bad turn of dice rolls.

My preference is that PCs that hit zero are just out of the fight, and we don't get to find out what happened to them until someone goes over there and checks them out.

 

[tetrasodium]

In any case, I'm not sure I like how in 5.5 the power of some common healing spells are almost doubled. How do people think this will affect things? I get that combat healing was often ineffective, but this seems like a lot. One houserule I was considering at one point, was that instead of doubling the dice like 5.5 did, some healing spells would let the PCs to burn hit dice for additional healing (one die per spell slot level.) This would achieve similar effect of increasing the spell potency, but would limit how much one person could benefit from it.

In some respects it's too early to say until we have the other books.... Monster manual especially. The useless 5e healing was almost designed to leverage yoyo/wackamole healing and that led to a cascade of sometimes difficult problems that the gm needed to fix if they wanted to go back to things like death at zero or capable monsters that could actually threaten PCs without needing to be unleashed via clowncar. Another test will be if the dmg has rules for recovery methods that are not trivial and explosive along with a bunch of other subsystems that desperately need revisions to not have a self nullifying impact on play.

 

[Crimson Longinus]

In some respects it's too early to say until we have the other books.... Monster manual especially. The useless 5e healing was almost designed to leverage yoyo/wackamole healing and that led to a cascade of sometimes difficult problems that the gm needed to fix if they wanted to go back to things like death at zero or capable monsters that could actually threaten PCs without needing to be unleashed via clowncar. Another test will be if the dmg has rules for recovery methods that are not trivial and explosive along with a bunch of other subsystems that desperately need revisions to not have a self nullifying impact on play.

This will not get rid of whackamole healing regardless. That would require there being some actually impactful downside for going to zero, so healers would need to focus on keeping people up.

 

[Cap'n Kobold]

I really think the issue here is a mismatch of priorities. Some of us want something resembling the actual experience and challenge of battlefield healing, and some of us want to minimize the time a player spends "out of action" during combat.

Those two are not mutually exclusive.

No reasonable DM wants to make a player sit out a significant chunk of the session while everyone else is excited and engaged in the combat their characters are involved in. Giving the other players an incentive to prevent characters being downed characters or get them back in the fight and effective tools to do so is a good way of solving that issue.

Currently a lot of people are focused on the incentive to avoid characters going down, and then being brought back up in a state where they will drop again. However there seems to be an unhealthy focus on punishment rather than changing or providing systems that will allow this to be prevented.
That's like underfeeding your dog, then beating it when it chews on your boots.

Good, nothing is more frustrating that pounding on a bad guy to see them healing faster than you can dish it out - same for the reverse for the DM. Attritition should exceed healing so fights don't last forever.

Spell slots are a finite resource and actions in combat are precious. Spending spell slots on healing to maintain hit points is still attrition even if the healer can prevent someone from dropping while they are doing so.
The more effective healing spells are touch. Using them should be at least as effective as maintaining the party's health by staying back and casting ranged spells like Hold person, or Command, which is currently incentivised.

Save the healing for after one side emerges victorious. In combat healing should, at best, give you an extra round or so at the most to soak damage from an unexpected crit or otherwise bad turn of dice rolls.

That is a very death spiral and TPK-oriented system. I don't think that most DMs want to encourage that, let alone players. There should be functional tools to recover from bad luck available should the party choose to employ them effectively.

 

[The Sigil]

This will not get rid of whackamole healing regardless. That would require there being some actually impactful downside for going to zero, so healers would need to focus on keeping people up.

Since I'm someone who is happy to steal from multiple sources, when I find a rule that does the job, I steal it for my games.

If you prefer to have an impactful downside for hitting 0 hp, I would advocate stealing the "Wounded" rule from PF2E to put some downside to going to zero, at least as a start. Here's how I would modify from PF2E as written for use in 5E.

If your hit points reach 0, you are unconscious and gain the condition "dying 1" (The "dying" condition always has a number after it).
If you take damage while you are already dying, increase your dying condition by 1.
A critical hit against you while you are dying increases your dying condition by 1 (in addition to the increase from taking damage).
At the end of each round, if you have the "dying" condition you must make a Death save.
If you fail a death save, increase your dying condition by 1*.
If you ever hit "dying 4" you immediately die.

If you make a Death save, reduce your dying condition by 1.
If your dying condition is reduced to 0 following a Death save or if your hit points are raised above 0, you lose the "dying" condition but gain the "wounded" condition instead with a value of 1 (if you already have the "wounded" condition, raise the value by 1).

If you ever gain the "dying" condition, you add your current "wounded" condition to the dying level.
You lose the wounded condition after either (1) a long rest or (2) being brought to full HP by any means followed by a short rest.

This introduces risk in going down a couple of times; for example, if my fighter hits 0 HP and gets "dying 1" - then the cleric slaps a Cure Wounds to take the fighter up to 5 HP. The fighter is now "wounded 1." The next round the fighter gets whacked again and drops to 0 HP - he's now "dying 2." Again, a heal spell brings the fighter back to positive HP and the fighter is "wounded 2." A couple of rounds later, the fighter takes another hit and is "dying 3." A single failed death save at this point will mean the death of the fighter. Fortunately the healer is quick and brings the fighter back to positive HP a third time. The fighter is now "wounded 3" - and if the fighter's HP ever drop below 0 again prior to full heal and/or rest, immediately the condition is "dying 4" - which means "dead." No death saves, no nothing. But then, healing has already let the fighter cheat death thrice, so... maybe retreat first?

* Note that you gain dying 1 when you drop to 0 HP or below. Three failed death saves means your condition will progress to dying 2, then dying 3, then dying 4 at which point you die. So you can't die any faster on your first knockdown than under current rules... and while it does make it possible to bleed out in the face of three successes (think "fail > dying 2, "fail > dying 3", "succeed > dying 2", "succeed > dying 1", repeat fail/fail/succeed/succeed ad naseum) I think the fact that it lets you fail three times and live (provided you succeeded at least once) offsets that.

Personally, I find that mathematically, this is a tiny bit of downside overall (only comes into play after the character goes down for the second or third time), but leads to situations where players that have dropped a couple of times are very much in favor of a tactical retreat ("live to fight another day") as the risk for being dropped again is heightened each time.