More on Healing in Pathfinder: Treat Wounds
Comparing Treat Wounds against previously inspected healing options
RPGDESIGNPF2
Ali Kutlu Durşen
8/11/20268 min read
Previous post on PF2e's healing led to some discussion (thanks to everyone who read it!) and it's best we start by responding to those:
What About Garden of Healing?
While doing research for easily accessible sources of healing, I did see that spell, considered it too powerful and moved on. That was a mistake.
That spell is also a mistake, I believe. PF2e's design philosophy clearly tells us that 2-action focus spells should be stronger than cantrips but weaker than a spell of same rank. Garden of Healing is a 1-action (but sustained) focus spell that can heal each hurt character for 1d4/rank per turn. A comparable spell, Cloak of Light is 1d6/rank per turn but 1) it's a slotted spell, not focus, 2) its heighten scheme is +2d6 per 2 ranks so less flexible, 3) it's 2-actions, as well as sustained 4) it's first available at 7th level 5) most importantly, it heals adjacent living creatures, a significant limitation compared to Garden of Healing's 10-foot emanation. Still, I'll give it to Cloak of Light that it's a very good healing spell, especially compared against AoE Heal's 1d8/rank. (Bonus limitation: does Cloak of Light heal its caster? It seems like RAW answer is no, but I may be tempted to say "yes" at my table.)
So in an environment where Cloak of Light is a very good healing option, what does that say about Garden of Healing? It tells to me that either Paizo designers strayed heavily from initial design approach in favor of making later options more powerful (a "power creep," one might say) or there are some serious editing problems around. Nonetheless, let me offer my weakened version:
Garden of Healing can heal one creature per turn and they get their +1 circumstance bonus against emotion effects immediately, not after the spell ends. Once the spell ends, healing targets are still immune to further healing from Garden of Healing for 10 minute afterward as is the case now.
In my opinion, even with this change this spell's way too strong, especially compared to Heal, but I hold back further change (where I say each target can be healed only once) until I have a chance to test this version at the table.
What About Scroll of Heal?
Okay, this is actually my criticism to myself. In my previous post I criticized previous editions' "cheap ways to heal" approach, comparing linear increase of hit points and exponential increase of character wealth.
But this is still mostly the case in PF2e. So what's different between the two cases?
In PF1e we're looking at a ratio of 3gp/hp (15gp per wand charge that heals 1d8+1, on average 5). In PF2e that ratio is 1gp/3hp (4 gp per scroll that heals 1d8+8). So it seems like PF2e offers the cheaper healing. However, this is not the whole picture. First, due to how PF1e characters roll a die to determine hp while PF2e characters effectively take the maximum value, high-level PF2e parties have around 40% hp more than their PF1e counterparts. Second, while PF2e's economy is still mostly exponential and wealth largely doubles at every other level, base values are different. PF2e characters' wealth reaches above 1000gp at 8th level, a sum that PF1e characters expect to see by 2nd level. At 20th level, amounts in question are 112,000gp and a whopping 880,000gp!
This means that healing a PF1e party from 0 to full health by virtue of wands costs a respectable 15% of total wealth (of one character) at level 2, which drops to 5% by level 4, below 2% somewhere between levels 8 and 9 and finally below 1% at level 13. It ends up being .25% of a characters wealth by 20th level.
On the other hand, to heal a PF2e party from 0 to full health by casting Heal from scrolls require about 1.5 times (that is, 162%) a starting character's wealth at level 1, drops below 50% at level 4, below 10% at level 9. From there, the decrease is more dramatic: it is below 5% at level 12, below 1% at level 17 and finally ends up being .33% wealth at 20th level.
So yes, the issue still exists in PF2e, fill your bags of holding spacious pouches to the brim with thousands of cheapest scrolls and heal to your heart's content. At least here a bigger numerator (hp) and smaller denominator (wealth by level) makes the issue more manageable –for a while.
What About Treat Wounds?(!)
I mean, that's the meat of this post, so calm your exclamation marks. I told you I'd eventually get to it and didn't think it was that urgent.
"But it's free, therefore should be the default baseline to compare against!"
I disagree.
First, we must realize that non-rogue PF2e characters can specialize in 3 (all legendary) to 4 (1 legendary and 3 masters) skills. My "number go up" brain gravitates towards maximum increases to end up with 3 legendary skills, but maybe a "skill meta" has formed around the other option. In any case, by asking a character to invest in Medicine skill, we are asking them to spend 33 or 100% of their legendary skill budget on healing, not to mention two almost-mandatory multiplier feats of Ward Medic and Continual Recovery.
Your mileage may vary, but I find such an investment no less valuable than a 2nd level class feat. Blessed One is a common archetype and demands no further investment. Admittedly, it also benefits from multiplier feats of additional focus points and fast Refocus, but those have in-combat benefits on top. You need a third skill feat (Battle Medicine) to see in-combat benefits of Medicine, or another one (Advanced First Aid) to see utilitarian benefits. At which point we can look at Mercy feat chain of Blessed One and the discussion goes on and on.
I hope you can see why I easily discarded Treat Wounds to another post. Oh, one more thing:
Treat Wounds: It's Not Even That Good
Of course, even not being that good would stop me from opening my spreadsheet to draw some graphs.
To evaluate Treat Wounds' efficacy, I simulated a character. My build rules were:
Key attribute is not Wisdom. I picked starting wisdom as +2 to represent a reasonable middle-ground. It's increased at every possible point to end up at +5 level 20.
Proficiency increases at first available level: 3 (expert), 7 (master) and 15 (legendary).
While I gave Medicine items, they are handed 1 level later than Automatic Bonus Progression would suggest: 4 (+1), 10 (+2) and 18 (+3). While our character is the party healer, they have other jobs to do and other skills to consider as well.
I also evaluated using Treat Wounds at lower DCs than possible, expressed in red line. You'll note that it's mostly flat: you have 5% failure chance (usually, even when you roll 1, you fail rather than critically fail) and increasing critical success chance.
One key observation: it's not ideal to use higher DC whenever you can. Indeed, at levels 7 to 9 and 15 to 17, you should still be healing at expert and master DC, rather than master and legendary DC, respectively. Honestly, this only makes sense: if we check DC by Level table, we'll see DC 30 at level 12 and DC 40 at level 20 and attempting those at levels 7 and 15 shouldn't be trivially easy.
I assumed our simulated character to be aware of this analysis and ran linear estimate on the "higher of the two" variable. You can see the result in yellow. This yellow line's slope is about 2.42, while Lay on Hands' is about 3 (396/133 to be exact). And keep in mind: Lay on Hands was the slower one between elixirs and potions. On average, Lay on Hands is more than 15% (sometimes up to 33%) more healing than optimal Treat Wounds usage.
Multipliers
Let's talk about Continual Recovery and Ward Medic. Let's see what they sound like at first:
Continual Recovery, at best, is a x3 multiplier when a single target sustains great damage: healing once-but-doubled compared to 6 times in an hour
Ward Medic, at best, is a x(Party Size, maximum 6) multiplier when whole party takes superficial damage and a single Treat Wounds is enough
However, actual play is never ideal.
Imagine a 10th level party of four faced and fought two level 10 monsters over three rounds. Each monster hit 2 times each round and dealt moderate damage (264hp). Looking at our table and seeing how Treating Wounds heal about 26hp at this level, we may be inclined to say it'll take 10 uses, or 11 for good measure (and to account for damage not being dealt in multiples of 26). Let's say all except the Wizard needs 3 Treat Wounds.
With no skill feats at all, it'll take 2 hour 30 minutes: 2x(40(TW for four)+20(waiting)) + 30(TW for three). Ward Medic, by itself, gives us: 2x(10(TW for four)+50(waiting)) + 10(TW for three), reducing overall time by 20 minutes and acting like a 1.15 speed multiplier. Continual Recovery, by itself, gets rid of the "waiting" part of the initial equation, giving us a reduction of 40 minutes and acting like a 1.36 speed multiplier. Together they are just 30 minutes, a multiplier of 5.
[An unmodified Lay on Hands spends 30 minutes on Barbarian, 20 each on Rogues and 10 on Wizard if we can afford to not top off them, for a total duration of 90 minutes. If we achieved the x3 multiplier, then it reduces to 30 minutes, same as Treat Wounds approach.]
Yet, this was another ideal situation where damage is spread evenly and both feats work synergistically. Let's look at a not-so-ideal case:
If these monsters focused on Barbarian (around 185hp) and ignored the others, and only then dealt a Rogue the remaining 80 damage, then Treat Wounds required would be 7 and 3. With no feats [but keeping in mind that a healer can work for an hour for double healing] we get 2x(60(double TW)) + 2x(20(TW for two)+40(waiting)) + 20(TW for two) = 4 hour and 20 minutes. Note: just by changing how the damage is spread, no-feat duration increased almost 2 hours!
When we consider feats, Ward Medic, by itself, is of little use: it only matters at the final (TW for two), reducing the overall time by 10 minutes and acting like a 1.04 multiplier. Continual Recovery, by itself, fares a lot better: from 260 minutes down to a 100 minutes, a 2.6 multiplier and much closer to its ideal case. With both feats available, overall duration becomes 70 minutes and overall multiplier is 3.71 Note: by changing the damage spread, even the both-feats duration is more than double the evenly-spread version's duration. Similarly, both-feats multiplier is a full factor below the evenly-spread's multiplier.
[An unmodified Lay on Hands spends 60 minutes on Barbarian and 30 on Rogue for a total duration of 90 minutes, well below the Treat Wounds approach. Note: damage spread did not effect Lay On Hands' required time due to its great flexibility.]
How Medicine feats actually behave
Despite sounding like x3 and x4 multipliers and then expecting a combined effect of x12, we should realize that these multipliers have conflicting requirements, are idealized and will not come to pass. It is better to see them as "around x1.5-x2 multipliers, each, in ideal scenarios" and then their combination as "x3-x5 multipliers, depending on conditions."
The Actual Multiplier
…were the friends we made along the way. Seriously, I said so previously as well: Instead of one character making a lot of investment towards healing, if multiple characters made smaller investments towards different healing methods it'd be more effective. It's a team game, after all.
In Conclusion
This thinking is what led me to say "healing is not free if you value your time" and my players seem to enjoy pushing deeper into a dungeon even when they are not at their best shape because they have a task to do. If you're in either "time is valueless, every fight at full hp!" or "PCs get back to full in 10 minutes!" camp, I hope this series of number-crunching and narrative-considering articles helped you see the game in a different light.
I also want to thank everyone discussing and replying, which helped me see the game in a different light –mostly bewilderment at Garden of Healing. I hear new classes have even stronger healing options! Can Paizo please stop carrying armament to "PCs get back to full in 10 minutes!" camp?
"Open locks, close wounds; it's all the same to me."