Getting The Most Out of The Heal Skill (in Pathfinder)

The Heal skill is one of those aspects of Pathfinder that most people just ignore. Aside from using it to tell how injured someone is, or how a particular corpse in a dungeon died, it seems like something that just isn't going to come up. However, like many skills in the book, you can do a lot with the Heal skill if you're willing to invest in it.

And sometimes it can be what saves your party.

Stop squirming, I need to get this thing out before you get a negative level...

The Heal Skill: What Can It Do?

Skills aren't magic, and while the Heal skill can restore hit points to a PC, you can't do it quickly. This makes it a poor choice for combat healing (most of the time, more on that later), but there is a lot of stuff you can use this skill for.

Stuff like:

- Provide First Aid: As a standard action you can make a DC 15 Heal check to stabilize a dying character, or to stop them from bleeding due to a bleed effect.

- Treat Poison: While tending a character who has been poisoned, every time they roll a save against the poison, you roll a Heal check. If your check exceeds the poison's save DC, then the subject gets a +4 competence bonus. Particularly useful for those who don't have other means prepared to neutralize a poison.

- Treat Disease: This works similarly to treating poison, and it can be a life-saver at lower levels when you can't cure disease with a wave of a hand just yet. It also takes 10 minutes as an action, so it's not great for in-combat use.

- Treat Deadly Wounds: This one takes a full hour, and expends 2 uses of a healer's kit. If you succeed, you restore a number of hit points equal to the creature's level, and if you beat the DC 20 by 5 or more then you add a bonus number of hit points equal to your Wisdom modifier. You have to do this within 24 hours of the wounds being delivered, and you can only do this once per day per target.

There are a few other uses of this skill (treating wounds from caltrops, long-term care, etc.) but these are the four most common uses. And chances are that most tables have only ever used the first-aid option. It's easy to think of this skill as one that falls by the wayside as you gain more expedient means of curing hit point damage, neutralizing poisons, and dealing with deadly wounds... but if you really want to invest in it, you can rev this skill up to the next level.

It's All About The Right Feats...

The feat you need to really juice this up is Healer's Hands, and it's found in the book Planar Adventures (the same book that gave us Magic Trick from How To Turn Floating Disk Into a Battlefield Spell). All you need is 1 rank of Heal and 1 rank of Knowledge (Planes), and you can take this feat. In short, it allows you to:

- Treat deadly wounds as a full-round action (instead of taking an hour).

- You don't take a negative for not using a healer's kit.

- You can use this action on a creature more than once per day, and if you beat the DC by 10 or more (it's a check of 30, for those keeping track), then you also get to add your ranks in Knowledge (Planes) to the hit points you heal.

You feeling better there, Jim?

Now, as a caveat, you can only use this feat's benefits a number of times per day equal to your ranks in Knowledge (Planes), and it only works on creatures that could be healed by positive energy. But say you're a level 10 character, you invested all the skill ranks, and you've got a high wisdom. Every time you treat deadly wounds on a fellow party member (without even needing a healer's kit, mind you), that's probably between 23 and 25 hit points you're giving them back (10 for their level, 10 for your ranks in Knowledge (Planes), and 3-5 depending on your Wisdom modifier).

At 10 times per day, that essentially gives you between 230 and 250 hit points you can restore without magic every day. Not a bad ability, eh? Especially if you add things like Healer's Gloves for that +5 competence bonus on your checks to make sure you hit that DC 30 reliably.

Then There's Skill Unlocks...

I'm the first to admit that there are not a lot of DMs who are willing to give players skill unlocks. First debuted in Pathfinder Unchained, they are an optional rule, but if they're in-play at your table then you can crack the Heal skill wide open.

And why is that, you might ask?

What you need to do is, when you get 5 ranks in the Heal skill, you take the feat Signature Skill. This gives you access to the skill unlocks for Heal, which start at 5 ranks. And every 5 ranks beyond that, you unlock another signature ability. Those are:

- Target recovers additional hit points and ability damage as if they'd rested a whole day.

- Target recovers additional hit points as if they'd rested a whole day with long-term care.

- Target recovers hit points and ability damage as if they'd rested for 3 days.

- Target recovers hit points and ability damage as if they'd rested for 3 days with long-term care.

We're going to have to do some math here to work this one out to its full conclusion. Because when you rest for a full day, you recover double your level in hit points, and 2 points of temporary ability damage. When you rest for a full day with long-term care, you recover at twice that rate.

So let's look at that level 5 unlock.

Assuming you make the DC 20 check on your fellow party member, you're automatically going to heal them for 5 hit points (their level). But with this skill unlock, you now heal them double their character level instead (10 points), and 2 points of temporary ability damage, as well. If you made the DC 25 check and you have a Wisdom modifier of +5, then you'll have healed them another 5 points, for a total of 15 hit points as a full-round action. 20 hit points if you manage to hit that DC 30 (unlikely, but possible with the right build).

And you'd be able to do that 5 times per day... putting your healing capacity at between 50 and 100 hit points, as well as 10 temporary ability damage, you could heal per day with no magic and not even a healer's kit!

The numbers just get more gross from there, my friends.

So what about at level 10? Well, the skill by itself heals them for 10 hit points. With the skill unlock, though, they recover 40 instead of 10, because it's treated as if they had a day of rest with long-term care (quadruple the normal healing). They also gain back 4 points of temporary ability point damage. Then if you hit the DC 25 check, you get to add your +5 modifier to bring that up to 45 hit points, and if you hit the DC 30 modifier you could bring that up to 55.

So the total here is between 400 and 550 hit points worth of healing in a day, as well as 40 points of temporary ability score damage.

The math only gets more nuts from there. At level 15 we're looking at more than 900 hit points per day of straight healing, and more than 70 points of temporary ability damage. At level 20, assuming your game goes that far, you could in theory heal over 2k hit points per day, as well as fix more than 200 points of temporary ability score damage.

Who says every party needs a cleric?

Useful, or Broken?

On the one hand, it could be argued that the skill unlocks provide you a meaningful way to make skills a bigger part of the game, and in this case to meaningfully heal fellow party members without the presence of a divine caster or potion spammer. However, when combining the skill unlock rules with this extraplanar knowledge of healing, you may find yourself dealing with a party that is all but immortal if they survive a given fight.

Tis but a flesh wound... have at thee!

Independently, the feat and unlocks are okay, if not great. My two cents, if you intend to use a system like this to replace the need for clerics and divine casters except in instances of permanent ability drain or negative level drain, then limit the number of times the character can use the feat Healer's Hands to their Wisdom modifier times per day (or perhaps double their Wisdom modifier per day, if you're feeling generous). That gives them the ability to meaningfully heal fellow party members with a skill, instead of magic, but doesn't give them the ability to wade through battle after battle for a full day without once casting a healing spell.

Just my two cents on finding a middle ground with this trick!

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