Medicine is a skill that, at least in my experience is under utilized in 5e. This is likely due to the abundant healing magics and abilities available to characters these days. Indeed with spare the dying as a cantrip and five 1st level healing spells (according to DNDBeyond) available to at least 8 of the classes there seems little need for Medicine proficiency or healing kits.
Others have touched upon this subject including:
- This Reddit post
- DM David (healing in general) I love this article and go back and read it often actually.
What’s Available Now
Let’s take a look at what is available right now. In the PHB the following classes have baseline access to Medicine during the character creation process: Bard, Cleric, Druid, Paladin and Wizard. This makes sense when you look at it. Traditional healers and knowers of things. The only background that includes Medicine is the Hermit which makes sense I guess?
I was surprised that Medicine was not available to Barbarians and Fighters. I ‘d think if you get into a few fights or spend some time by yourself in the woods (Ranger too I guess) you might want to know how to patch yourself up. I’m a poor judge here though. As a nurse, I think everyone should know the basics of taking care of themselves. Mostly so you stop coming to my clinic bitching about a sore throat that you’ve had for a day. ONE GODDAMN DAY.
Anyone is also able to take the Healer Feat instead of an ASI if you are using those rules (isn’t everyone).
There are a few things available for folks but what does that actually mean you can do?
This is how I’m defining the various skill levels:
- Non-proficent = random person on the street. Does not know CPR.
- Healer’s kit = First aid kit (my favorite song here) or perhaps a medic bag.
- Medicine proficiency = Medical Professional (RN, Paramedic). Someone who mindfully keeps up on skills/knowledge in this field.
- Healer feat = Someone with a talent for making people feel better. Good at what they do. This may be because they interact with their patients better but I know plenty of docs that are assholes but man do they know what they are doing. (I also have known providers with a ton of knowledge but very little ability to implement it, especially in an emergent situation)
Let’s look at this in terms of increasing skill level and available materials. We’ll examine what has been listed as possible by the current books:
- Non-proficent + ø healer’s kit– (Action) DC 10 Wisdom (Medicine) check to stabilize the dying.
- Non-proficient + healer’s kit– (Action) Stabilize the dying without a Medicine check.
- Proficiency + ø healer’s kit– (Action) DC 10 Wisdom (Medicine) check to stabilize the dying. (only benefit is the prof bonus)
- Proficiency + healer’s kit– Again the only benefit is the Proficiency bonus, but DMG pg implies Advantage could be considered.
- Healer Feat + healer’s kit– (Action) as #2 but the target also gains 1hp. OR (Action) 1 use of healer kit to restore 1d6+4+#HD to the target 1/rest.
Slight increases in probability of success comes with proficiency (makes sense) but you still can’t do anything other than stabilize a dying companion or diagnose an illness (no example given for this in the core books but The Malady Codex on the DMs Guild has some great examples and some real-world inspired diseases.).
I find the Healer Feat intriguing. It’s sole purpose is to augment the healer’s kit and has no synergy with Medicine proficiency. This feels off to me that someone with ‘a knack’ for healing or even basic training would be better able to aid another than a character with Medicine proficiency which represents continued training and expertise as they level.
Assuming that healing through rest will be harder to come by (insert link to blog post about ‘rugged’ healing rules). Let’s look at expanding the Medicine skill.
Let’s boost our options when we are proficient in Medicine (trained/educated/experienced) in addition to Stabilizing a dying companion and identifying an illness a player can:
- Identify a cure/treatment for an illness after it has been identified. If there are ongoing saves involved, successful Medicine checks can grant advantage to the player for those saves.*
- If specific cures are required (e.g. Sightrot), characters proficient in Medicine can create them with a successful check.
- Lingering injuries or disease effects from monsters can be mitigated by successful Medicine checks (DMG 272) Proficient characters need half as many checks to eliminate the ongoing effect (if multiple successes are needed).
- Characters proficient in Medicine can with a successful check (DC 15?) allow a character to spend Hit Dice without resting. The number of Hit Dice a character can spend is equal to your Proficiency Bonus. **
*I am mindfully separating identification of a disease from treatment knowledge. Sure Jim/Bob’s cousin might have had Sewer Plague once, but they recovered due to rest and not drinking a liter of salt water every morning followed by herbal tea and a cayenne pepper/maple syrup tonic.*
**For example, a 10th level character proficient in Medicine could with a successful check allow their companion to use up to four of their Hit Dice outside of a rest. This scales with proficiency, with more skilled practitioners granting greater recovery.**
Now that proficient characters can use Medicine to allow healing outside of a rest (at a cost) what does this mean for the Healer feat? Nothing. The healing granted by the Healer feat is bonus. It does not consume Hit Dice for that healing and can still be used on a character that has no Hit Dice left (but still only 1/rest).
I would probably mimic the Life Cleric: Disciple of Life ability and state that healing granted by a character proficient in Medicine and with the Healer feat includes two additional hit points. This then reflects the character not only has a knack for caring for others but maintains a state of readiness/expertise which results in higher quality of care and increased outcomes. (Goddammit. That’s some Joint Commision lingo I just cannot shake.)
- Stabilizing the dying would get 3hp
- Healer feat healing 1d6+4+#HD+2
That’s a lot of talk for…not much change. Mostly I examined my understanding for the things that are already available. I incorporated some additional ideas that others got to before me and then added the ability for healing outside of rest.
Personally I like this idea though it will likely only really have value in a setting that is low magic or in situations where healing magic itself is limited. Think Dark Sun (which is why I’m doing this) or Dragonlance before the return of the clerics.
I left a lot of wiggle room in the implementation though I hopefully communicated my thought process in developing this.
Thanks for reading. Please share your thoughts if you have any and if you can and you have not yet go and get your flu shot. It could save a life.