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Reading the description of the Heal skill in Pathfinder and comparing its outcomes to other ways of healing, such as wands, channel positive energy, etc., I have found that skill useless. The relatively low-to-non-existent cost per use and unlimited number of uses per day seem to be the only benefits.

For a party of adventurers, this seems quite useless due to the amount of time spent to achieve certain results — the adventurers don't have unlimited time. But, being new to the system, I want to hear if there is something beyond my current level of understanding.

Does the Heal skill have any real benefit over magical methods of healing?


This question has attracted many answers essentially based on house rules:

  • Wealth by level being severely reduced, even compared to the "low fantasy" threshold
  • The Heal skill being able to solve more problems than listed in the book
  • Access to magic items being drastically cut
  • Etc.

Such answers might be OK and might propose interesting house rules, but please, tell that your answer is based on a house rule if it is, and state your experience using it! Many of those rules turn Pathfinder in an entirely different game with a completely different balance.

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There is nearly-zero return on investment in Heal

This answer is all about cost–benefit analysis. That is, how much good does Heal do you, compared to what costs you have to pay to get those benefits. For the most part, Heal costs skill points, which are not very valuable, but they are strictly limited and almost every character wishes they had substantially more of them than they do. Which is to say, we don’t necessarily need to get a lot from our skill points, but we definitely want to get something.

Speaking of, you cannot talk about how good anything is in a vacuum; you need to consider how else you could achieve the same thing. In this case, we have to consider magical healing, most notably a wand of cure light wounds. A caster level 1st wand of cure light wounds costs 750 gp, which is an affordable figure for a party of four before even reaching 2nd level. By mid levels, it’s pocket change.

The short answer is, Heal is useless because it cannot replace magical healing, and you can’t ever afford to go without magical healing. Since it has no use, there is no reason to invest in it—it provides no return on that investment. There are only three exceptions:

  • At 1st level, since you cannot afford a wand of cure light wounds yet.

  • With Healer’s Hands and Heal’s skill unlock—uniquely, good enough to replace magical healing, though the cost is immense and not worth it in most campaigns.

  • To torture people, specifically to erode their Will.

Using Heal to heal

The most basic application of the Heal skill is to heal people: treat deadly wounds, cure diseases and poisons, and assist in the body’s natural healing.

Basic usage: only worthwhile at 1st level

The first thing to note is that Pathfinder changes massively between the 1st and 2nd level. Many of your stats literally double, and your wealth grows quite substantially. Where a starting character almost-certainly has no gear of significant value, a 2nd-level character can have some basic masterwork and magical gear.

This matters a whole lot: you cannot afford a wand of cure light wounds at 1st level. That means the Heal skill has lost its primary competition.

It also means that magical healing from class features is fairly limited, and there may be only one person capable of casting even stabilize—so if that person gets hurt, someone needs to try to perform first aid to stop them from bleeding out.

So all-in-all, Heal has some utility at 1st level. A 1st-level character who has it as a class skill might want to invest a single skill point in it, since they get a +4 improvement in the check for one point and they may actually use it.

But at higher levels, the ubiquity and necessity of magical healing triumphs, and hard. Every single party ever absolutely requires access to magical healing; the game is designed around it. Magical healing is so much massively faster that higher-level characters, with far more hp than 1st-level characters, require it to actually be able to continue their adventures. Spending an hour (!) to heal a tiny amount of hp (!), and then having to wait an entire day before you can do it again (!!!) means treating deadly wounds is a waste of time and will not help an adventuring party in any way. And magical diseases and poisons—the ones that are real threats—are often resistant to mundane healing, so it isn’s useful for that either. If such a party finds itself without magical healing, the Heal skill is not a replacement, not even an inferior replacement: the party must have magical healing. You cannot adventure without it.

So magical healing means you will never use the Heal skill. If you have magical healing, there’d be no reason to use Heal, and if you don’t have magical healing, you need to get it.

That means characters will rapidly stop using Heal for anything, ever. As a result, any skill points in Heal after that first one—each point only giving you a +1 on the check—does nothing for you, as you won’t be using the skill in the first place. There’s also no reward for hitting higher DCs—the best you can do is hit DC 25 to treat deadly wounds and add your Wisdom modifier—so once you have a +15 modifier to hit that while taking 10, there is literally nothing to be gained from more Heal ranks. As established, while we don’t necessarily expect much from our skill points, we definitely expect something.

Heal Unchained: nice improvement, but does nothing about the big problems

Pathfinder Unchained allows you to “unlock” skills, Heal included, to allow greater effects. For Heal, this means substantially improving the effects of treating deadly wounds, though even six times as much hp healing still does not result in anything like “substantial” hp healing. The six healed points of ability score damage is more significant, but this is also at 20th level.

Anyway, as written, unlocking either means specializing in that skill as an unchained rogue, or taking the Signature Skill feat. Rogues only get to unlock four skills total throughout their careers, however, while Signature Skill can be taken only once—unlocking only one skill.

So unlocking Heal is a high cost—usually. Rogues rely a lot on their skills and Heal is unlikely to be a top contender, so using 25% of their unlocks on Heal seems quite dubious. Five levels in rogue to get an unlock on a healer is a non-starter: so much magical healing has to be given up for that to be a thing that you will never recover—and yes, you still need magical healing, because treating deadly wounds can still only be performed once per day per creature. And Signature Skill requires taking a feat—itself a large cost—and also locks you out of taking Signature Skill for any other skill. Considering all of the problems with treating deadly wounds (once per day, taking an hour, the numbers still being small), that would be a terrible use of extremely scarce and valuable resources.

On the other hand, Pathfinder Unchained also suggests that skill unlocks could just be opened up to anyone with the requisite skill ranks, as a variant rule. If that is in play, the cost is a lot less... but probably not high enough to justify the skill points. After all, even with it healing more and healing ability score damage, treating deadly wounds still takes forever and still can only be done once a day.

Healer’s Hands: finally competitive with magic, but the cost is high

This feat from Planar Adventures allows you to treat deadly wounds without regarding for a healer’s kit, as a full-round action, and as many times per day as you would like.

Can you say every problem with Heal gone?

With Healer’s Hands, the healing provided by treating deadly wounds is finally competitive with a wand of cure light wounds. That is a massively big deal. You could legitimately go without buying wands of cure light wounds if you have Healer’s Hands. And if you unlock Heal—allowing it to heal ability score damage—you can also skip the pricier wand of lesser restoration.

That still costs probably two feats (or a feat and a major class feature, if you are a rogue). Two feats is monumental in this game. Is eliminating the need for healing wands worth that?

From a strictly monetary perspective, no. The wealth guidelines tracks wealth—the value of the items you actually have in your possession. When you have consumed a wand, it’s worthless—which means you don’t count it as part of your wealth. In short, buying a wand is a temporary expense, not a permanent one. By the rules, you should recoup that expense in the course of your travels, simply because you will use it up and your wealth should recover.

Even if we ignore that—and in extremely abusive situations, the rules for wealth recommend you do, though standard usage of these wands shouldn’t be considered “extremely abusive”—the wand of cure light wounds is still extremely cheap. A feat is worth—minimum—10,000 gp. You can buy 13 wands of cure light wounds for that money and still have some left over. That’s 3,575 hp worth of healing, on average. How quickly are you likely to take 3,575 points of damage that will need healing, to make Healer’s Hands worth it (only considering hp healing for the moment)? There is an extremely good chance that you will never do so. Especially since you can buy wands of cure light wounds as you need them, but you have to “buy” the feat all as one big lump sum.

Now, if you unlock Heal, treating deadly wounds also heals ability score damage—and a wand of lesser restoration is more expensive (4,500 gp). Then again, ability score damage is also far less common. Will you actually go through all 50 charges on that wand? Will you do it twice? Depends a lot on your campaign, but still seems pretty unlikely. And now you’ve used two feats, which is immense.

The other major advantage of Healer’s Hands is it doesn’t run out or require any resources. While wands of cure light wounds or a wand of lesser restoration are probably less costly overall, that doesn’t help you if you need to buy one and you’re nowhere near anyone selling one. Proper preparation can largely alleviate this as a concern, but this is nonetheless a major advantage.

In short: where no one should ever invest in Heal without Healer’s Hands, there is enough return on the investment in Healer’s Hands to make it a valid choice in the right campaign for the right character. In most campaigns, it isn’t quite worth it, but it’s close enough to be argued, and the right campaign could easily tip the needle on that.

Finally, because Healer’s Hands makes treating deadly wounds a full-round action, you could consider doing it in combat. Please don’t—even with the skill unlocked, you are healing less than one attack’s worth of damage at a time. At best, if an ally is bleeding out next to you, it might save their life, but that’s a really unlikely scenario—and even in that case, it’s not actually helpful if the enemy is still there and just undoes it, and can still do other things besides. You are far better off clearing out the danger first. The only healing you should really be using in combat are stabilize—in emergency situations—and heal.

Using Heal to improve magical healing

This isn’t a thing. Magical and mundane healing are completely independent, and having skill in Heal does absolutely nothing for your healing spells.

This is also the important difference between the Heal skill and, say, the example of a mundane weapon. “Mundane” weapon skills are “free” for someone who gains “magical” weapon skills, because of course there is no such thing as “mundane” weapon skills or “magical” weapon skills. Weapon skills are weapon skills, whether the weapon is magical or not. But mundane and magical healing are completely separated, and your skill with one doesn’t affect your skill with the other in any way. You don’t get any benefit at magical healing for having skill at the Heal skill—and having magical healing ability doesn’t make you any better at using Heal.

So unlike a non-magical weapon, which a warrior would use in a pinch because all his feats and class features he intended to use with a magical weapon also work with a non-magical weapon, a magical healer deprived of magic isn’t automatically also good at healing. In order to be good at mundane healing, he has to independently invest resources in the Heal skill. Doing this does not aid him in any way when he can use magic, and as discussed, magical healing is necessary.

Using Heal for diagnosis or anatomical knowledge

This isn’t a thing either. The rules give zero indication that you would use a Heal check for this—everything to do with knowing something about a creature falls under the appropriate Knowledge skill, as the rules are written. A few published adventures give custom uses of the Heal skill for particular set-piece challenges that work this way, but those cannot be generalized outward to the rest of the game, barring a houserule. Technological Guide mentions something about Heal being used to identify drugs and pharmaceuticals, but zero information is given about how that works—and Technological Guide is fairly unusual in a Pathfinder game anyway.

So while being able to diagnose problems would be a useful thing, the Heal skill doesn’t actually cover that. You would need Knowledge, local for most humanoids, nature for animals, and so on.

Using Heal to torture people

Villains: Rebirth gives a new usage of Heal for torturing people. Most of the options are garbage—and torture is not a reliable means of extracting actionable intelligence, which the rules reflect by not making it so in the game. As GM, I would give anyone massive circumstance bonuses on their Bluff check, since the incredible stress of torture make detecting any “stress” one might feel from lying undetectable. I recommend other GMs do the same.

However, one of the things you can do with torture is wear down a target’s Will save. That can be terrifyingly effective, since it can allow you to then use magic on them. There are probably quicker, easier ways to do it, but if you have the luxury of time and a secure, private location to perform the torture, it could be worthwhile for a high-value, high-Will target.

Or, if you want to do this as a large-scale, continuous operation, it scales phenomenally: if your evil tyrant makes a habit of imprisoning people in cells that erode their Will for a month before dealing with them, then even a low-level minion could spend each day casting charm person on several people, with all-but-guaranteed success. You could therefore have a facility capable of dealing with dozens of political prisoners per day, manned by only a few low-level spellcasters. Without eroding their Will, each prisoner would probably require a high-level spellcaster, and/or several wasted spell slots getting the spell to stick, before they could be dealt with, so this approach is very efficient.

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  • \$\begingroup\$ to be exhaustive, Heal is also used to attack some object : aonprd.com/… (heal DC 20) or recover some ability damage from ninja ( Pressure Points* (Su) -1 dex or str, heal DC 15 to remove) \$\endgroup\$
    – Alkano
    Jan 11, 2021 at 11:02
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When it comes to healing, if you have access to magical healing for the thing you want to fix, that's pretty much always preferable. The key advantages of the Heal skill is that it's a single skill that covers everything, and does so starting at 1st level.

Picking up the Heal skill allows you to stabilize people, give them long term care to restore their HP and recover ability damage, treat poisons and treat diseases. Doing all of that with magic requires a large number of different spells, some of which are quite high level. Until you reach the right level, and have the money/spell slots to afford repeated use, you might have to rely on the Heal skill to perform these tasks.

Compare it to asking "why would I wear Splintmail, if I can wear Full Plate Mail instead?". The answer is that you wouldn't, but if you're going into combat now and you only have the money to buy the Splintmail, it's certainly better than nothing.

The Heal skill is an inferior option compared with magical healing and comes at a cost in skill points, but if you don't have magical healing yet, it's better than nothing. It might be better to sink some skill points into Heal than to die from a scorpion sting before you learn how to cast Neutralize Poison.

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There is one more use of the heal skill that hasn't been covered by the other answers yet. Investigation and role-playing.

GM: The murder victim is lying on the ground, cold to the touch

Player: I check the body, how long do I think he's been dead?

GM: Roll heal skill.

Other similar questions such as "what killed him", heal could be relevant to. Equally if you ran into a disease or plague, heal could help identify it - especially if the plague is magic resistant.

Complicated surgery might be needed on a target, something where magic for whatever reason isn't enough. Maybe there is a parasite inside someone and you need the parasite removed alive. There's no spell for that.

Essentially what I'm saying is that the heal skill may be less powerful than a spell. But it's always available, you never run out, and it's more flexible. I've used many of the examples above or similar in my campaigns with considerable success.

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    \$\begingroup\$ Basically, Heal covers anatomy. In D&D 3rd this was actually specifically stated. \$\endgroup\$
    – Weckar E.
    Mar 22, 2017 at 9:27
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    \$\begingroup\$ In pathfinder, doing so is a house rule though, as that use is not covered by the system. Knowing/guessing a cause of death is in the territory of Profession(Pathologist). \$\endgroup\$
    – ShadowKras
    Mar 22, 2017 at 17:33
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    \$\begingroup\$ But if you require some official ruling, the Horror Adventures brings us this (the closest we got): The special properties of a disease with a template are difficult to predict without special training. Unless a character spends at least an hour examining the disease and its victims and then succeeds at a Heal check (DC = the disease’s save DC + 10), she identifies the disease as its more common variant, without realizing the differences. \$\endgroup\$
    – ShadowKras
    Mar 22, 2017 at 17:41
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    \$\begingroup\$ I also want to point that all parasites that have been released on official books are either treated as disease, or curse/disease (so you first must remove the curse), or will specific that remove disease can remove the parasite. \$\endgroup\$
    – ShadowKras
    Mar 22, 2017 at 17:45
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Does Heal skill have any real benefit over magical methods of healing?

No, it does not.

Magic can fix everything, even death. That said, Heal is a mundane skill, for characters without magic, or for characters who want to use their magic for something else.

Most classes with access to healing spells will also have access to spells like Restoration, Neutralize Poison, Remove Disease, all of which can duplicate the effects of the Heal skill, sometimes are even better. Magic can remove the condition and the effects caused by it.

Magic is a limited resource, the skill is not

Depending on your character level (specially at lower levels), your spell slots are your real limitation on the topic of how much can you heal. Spells have a limited use per day, even for characters that can use healing at will (like witches).

If your group is running against the clock, you may not have the time to sit for a day and prepare the necessary spells to heal the group. Or you might not have the money to pay for it if your group cannot cast a certain spell. While certain uses of the Heal skill will only take a round or a few minutes, like treating a disease for 10 minutes per person (per day) to grant them a +4 bonus on their save.

Example: If you are a 5th level cleric, you have access to remove disease. When you cast the spell, you roll 1d20+5 against the disease DC. While applying the heal skill to yourself will grant a bonus of at least +8 on the save (4 base from your class, +4 from heal) at no cost on spell slots. Other characters on the group might have a better or lower fortitude bonus, but that's something you will have to consider and weight if the use of a spell slot is necessary or not.

Poison

A poison normally has a short duration, a few rounds at most, but the effects can be devastating.

While you can use Neutralize Poison to quickly remove a poison from a character, you may not have enough slots to prepare it a lot of times. Waiting for a day to remove a poison is pointless then, as you will be healing the damage caused by the poison by then.

A character's life may depend on quick use of the Heal skill instead, specially if fighting many poisonous opponents. Because poisons can stack and it increases both the DC to remove the effect and the duration.

So the only two reasons to use the Heal skill would be to save spell slots and to save time.

If you do have time, prefer magic, always. And if you do have money, then go magic aswell. A single Wand of Cure Light Wounds will be more valuable to your group for the first levels than someone with ranks on Heal. And you might keep buying those well past the first levels if your group is capable (one of my groups would carry 4 wands of CLW by 9th level).

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    \$\begingroup\$ +1 for characters without magic. If your healer is injured or missing, a soldier that can apply first aid will save lives. \$\endgroup\$ Mar 21, 2017 at 14:12
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    \$\begingroup\$ The skill is often limited by uses of a healer’s kit. Treating deadly wounds, for instance, requires not one but two charges out of one. And the ability of non-magical characters to use it ignores the existence of Use Magic Device—points spent there instead of Heal provide vastly superior healing in the form of magic wands, which are the best way to provide healing anyway. \$\endgroup\$
    – KRyan
    Mar 21, 2017 at 14:42
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    \$\begingroup\$ It is not required, you simply take a -2 per use of a kit missing. For other purposes, the kit simply adds a bonus. \$\endgroup\$
    – ShadowKras
    Mar 21, 2017 at 16:02
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    \$\begingroup\$ Heal skill also isn't affected by things such as anti-magic zones. This is a rather big advantage sometimes. \$\endgroup\$
    – Leliel
    Mar 21, 2017 at 23:55
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In the rules about the heal skill you can see there are several uses for it:

  • Provide first aid: quickly useless for any normally constituted party, but useful when your cleric needs to be stabilized and you don't have any secondary healer.

  • Provide long-term care: saves some uses of Lesser Restoration (lvl2 spell on pretty much all healer caster's list). It may be useful before lvl3, or if your cleric has lost a ton of wisdom.

  • Treat Wounds from Caltrops, Spike Growth, or Spike Stones: these conditions are both not that terrible nor that frequent, and a cure spell works too.

  • Treat Deadly Wounds: can have some use at low-level if you don't have any cleric, or in very-low-magic settings, otherwise it's crap.

  • Treat Disease: can be useful before lvl 5, then there is a better spell. Usually you can wait the next day before healing a disease.

  • Treat Poison: useful when you don't have the right spell ready. Usually you can't wait the next day to prepare the spell to heal a poison.

  • Something that is not mentioned here: you can use it to stop bleeding. Magic does that better, but still worth mentioning.

So, to sum up the (very few) advantages of the heal skill over magical healing:

  • It's a skill, so you are not limited in uses par day (you can use it on top of spells if you want)

  • It can make you able to solve problems (poison, disease) with a lower level than the one required to cast the spell (but less reliably)

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    \$\begingroup\$ Could the ones down-voting this explain why? I can accept that my answer is bad, but knowing more about it makes me able to improve. \$\endgroup\$ Jul 31, 2017 at 8:25
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    \$\begingroup\$ The answer looks fine to me (in fact I upvoted it originally). Does it add anything to the other answers though? If not that may lead to some downvotes. \$\endgroup\$
    – Tim B
    Aug 1, 2017 at 21:07
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    \$\begingroup\$ People looking don't always see that though. Tbh it's not worth fretting about downvotes unless you get a lot. Some people just don't like some answers. \$\endgroup\$
    – Tim B
    Aug 2, 2017 at 11:55
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Update: Heal is viable, and surprisingly potent

Thanks to the new Planar Adventures book, the Heal skill has gained viability as both an out of combat or in combat healing option. Discussions like This thread or This other thread on the Paizo forums contain both elaborations on the method and the arguments about how it works, but it basically boils down to this combination:

  • Acquire the Healer's Hands feat from Planar Adventures

  • Put ranks consistently into both Heal and Knowledge: Planes

  • Acquire the Unchained Skill Unlock for the Heal Skill, whether through Signature Skill feat or the Unchained Rogue's Rogue's Edge class feature.

Healer's Hands allows a character to use the Treat Deadly Wounds feature of the Heal skill as a Full Round Action without using a healing kit a number of times per day equal to their ranks in Knowledge: Planes. Additionally, if the character passes the Heal DC by 10 or more, they may add their ranks in Knowledge: Planes to the healing done. Treat Deadly Wounds has a flat DC of 20, so triggering this effect is a DC 30 Heal Check. A character with Healer's Hands can use Treat Deadly Wounds on a patient multiple times per day.

The skill unlocks for the Heal skill allow Treat Deadly Wounds to restore the target as if the target had rested, increasing the HP healing and additionally healing ability damage. These effects improve as the character puts more ranks into the Heal skill, adding the benefits of Providing Long Term Care, and eventually the benefits of multiple days of rest in a single use of Treat Deadly Wounds.

When combined, these two effects allow for a character to potentially heal substantial amounts of HP. An example 10th level character with 10 ranks in both Heal and Knowledge: Planes performing Treat Deadly Wounds on a 10th level character would restore 40 HP and 4 Ability Damage. If the healer rolled above a 30 on their Heal check, that then becomes 50 HP and 4 Ability Damage. This is done as a Full Round Action, and can be done by this example healer a total of 10 times a day to any combination of targets he wishes.

So how does this stack up against already existing options? One of the most economical options for out of combat healing is a CL1 Wand of Cure Light Wounds, at 750gp for 50 charges. Each charge heals an average of 5.5 (1d8+1) HP, so an average of 7-8 charges need to be used to match the healing of a single use of Treat Deadly Wounds. The wand only heals HP, while Treat Deadly Wounds additionally recovers Ability Damage that would need to be handled by higher level spells such as Lesser Restoration. Additionally, Treat Deadly Wounds does not cost gold, while the Wand will eventually run dry and require the expenditure of gold to replace.

In combat, the Heal spell is still king. Until Heal is an option, however, Treat Deadly Wounds is a viable alternative to curative spells. Using our example at 10th level, a Cleric's most powerful healing spell available is Breath of Life, at 5d6+10 HP (Average 27.5). In this case, Treat Deadly Wounds heals more raw HP, and also covers some Ability Damage, at the expense of the additional action cost (Full Round Action instead of Standard Action) and the potential of Breath of Life to restore a dead ally.

In summary, the Heal skill can, with the investment of 1-2 feats and 2 skill ranks per level, potentially heal just as well or better than curative magic, in a completely mundane fashion.

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  • \$\begingroup\$ How does it compare to Wands of Cure Light Wounds/Wands of Infernal Healing/Wands of Lesser Vigor paired with a Wand of Lesser Restoration? Especially in cost-effectiveness? Seems like this comparison is still not in favor of the Heal skill. \$\endgroup\$ Jul 11, 2018 at 14:56
  • \$\begingroup\$ @Baskakov_Dmitriy In terms of cost-effectiveness, Healer's Hands removes the need for a healer's kit, so Treat Deadly Wounds no longer has a gp cost, only a uses/day cost. The utility offered here is that the Heal skill can offer restoration on a comparable scale to repeated wand usage at no gold cost for a number of times per day equal to your level. Depending on your level and the number of combats faced in a day, it can act as a significant supplement to the wands, or potentially replace them entirely. \$\endgroup\$ Jul 11, 2018 at 18:51
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    \$\begingroup\$ Basically, you pay: one feat, a lot of skill points that go to Knowledge (planes) and Heal (1 per level), which sounds kind of a lot, and you still don't have effective combat healing. That's clearly a lot better than just losing a lot of skill points invested in the Heal skill, but that's also probably extremely expensive in terms of resources invested. Seems like a good thing to ask about in another question! \$\endgroup\$ Jul 17, 2018 at 9:04
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Not too long ago we had a situation where a party of 5 fought a phase spider and at the end of the fight 4 were injured and poisoned. At least some of us were in danger of dying because of the combo of hp damage and con damage.

Casting lesser restoration takes 3 rounds, not a good investment when time is an issue. Casting cure spells helped but only one of us had any with too little slots to top of everyone. Despite playing an AP (Adventure Path) we were FAR below WBL and thus could not afford a wand of CLW.

What we did was: Every one except the one with the lowest roll used the heal skill on someone else and in the end (when the poison ran out) everyone was still around because some successful heal checks resulted in successful saves that would otherwise have failed and the lone potion of lesser restoration we had was given to the one closest to dying.

And even without the low wealth it would have been a good use of ressourses to use the heal skill in this situation because every save that succeeds because of the bonus given by it means at least one lesser restoration that is not needed to get the party back up. A party of 5 were 4 have massive con damage can't go adventuring effectively. And at level 5 with only one who can cast lesser restoration it may take several days to heal all that ability damage.

I don't say anyone should max out the heal skill. But to put in a single skill rank if it is a class skill can make a difference and by that is a ressource well spent.

Apart from all the above it is a role playing tool. Player characters are not only numbers, they are personalities. And each one should have some skills that are not only strong choices but round out a character. For a good cleric that can be enough incentive to put a rank into heal.

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The heal skill can be used to conserve magical resources (and works when those are not available, which is not too infrequent at low levels, in my experience):

  • Provide first aid: Niche use of the skill. Note that you can use it on yourself, which is nice if you do not have healing magic but have stabilized after otherwise-TPK or after you were left for dead.

  • Provide long-term care: If many characters in the group are wounded (even after expending healing magic available that day) and someone can provide long-term care, then it heals hit point per level extra (and ability damage) when resting. This is likely to conserve a couple of cure spells or add a few extra hit points to someone that would not have been worth using a healing spell on. And, of course, if you choose to wait for a day or more, this skill makes natural healing quite fast and is quite effective at, for example, recovering from a fight with shadows where everyone got their strength damaged.

  • Treat Deadly Wounds: If you have someone with +4 or higher total bonus on heal skill and have to wait for an hour, you should use this with the -4 penalty for not expending uses from a healer's kit. Why not?

  • Treat Disease: Fast to use (10 minutes), so you should try whenever someone is ill. Why not?

  • Treat Poison: Very fast to use (1 action), so do this whenever you are not fighting or can't contribute in a useful way in a fight, but someone is poisoned.

  • Treat Wounds from Caltrops, Spike Growth, or Spike Stones: Quite rarely useful.

The heal skill is useful if you have it, but is it worth spending skill ranks on? I'd say a rank or two are a sound investment for at least a character or two in a party, supposing they have heal as a class skill. This gives a chance of succeeding at treating deadly wounds and makes long-term care and helping to fight poison and disease succeed half the time (with average wisdom) or 3/4 of the time (with very high wisdom).

Another use is in sandbox play or some other circumstance where the world responds to your actions: By treating deadly wounds, you can adventure for longer, and hence achieve more before having to rest, with all that entails: Enemies regroup and prepare for you, monsters move around as the megadungeon is restocked, and enemies might send a strike force or assassins to take you down.

Depending on your GM/referee, you might also use the heal skill to figure out how someone died.

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What happens if no one wants to run a Cleric? We did this once in a campaign. Our healer was the Bard (plus almost everyone had a few ranks in heal). This worked very well since our group generally wades through par CR battles.

It is good for when the characters are low level, for when the cleric wants to do things other than spam Cures, low magic settings, anti-magic zones, and many other cases.

Using the Heal skill will save charges on the Wand of Cure Disease or Wand of Neutralize Poison. So, even if it's a group of min-maxers, there is still a use for the Heal skill.

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    \$\begingroup\$ I dont know why this is downvoted. \$\endgroup\$
    – Drew Major
    Jul 23, 2018 at 4:06
  • \$\begingroup\$ @DrewMajor, the downvote fairies found it. I used the term min-maxer that tends to get downvotes from the self conscious. \$\endgroup\$
    – ShadoCat
    Jul 23, 2018 at 5:45
  • \$\begingroup\$ I was tempted to write a response etailing that there is no point to any skill or ability because at the end of the day a spell can do any of them better, but I am pretty sure it will just load me up with downvotes as well. \$\endgroup\$
    – Drew Major
    Jul 23, 2018 at 21:24
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Another use that I haven't seen mentioned here is that the Heal skill also covers knowledge of medical subjects. It allows your character to diagnose the issues a patient might be having before wasting spells on them. To a character without the heal skill, the effects of some poisons, diseases and ability/level drain look identical.

If the GM enforces the difference between out of character and in-character knowledge in a fairly strict manner, you might not be told what it is exactly that's draining your strength.

As an example: In a campaign I was playing in we got into a scrap with some vampires, creatures notorious for causing level drain. The cleric didn't have the heal skill. (Their method of dealing with injuries boiled down to: "If it bends wrong or is bleeding, cast cure spell, otherwise, stop being a wuss") They'd usually throw down a (lesser) restoration if a condition proved to be a big issue but not regularly.
One of the characters had gotten hit by the vampires and ended up suffering from both the Bubonic Plague (from the vampire's claws, if I recall correctly) and level drain. Not having any medical expertise, the cleric called said character a wuss and promised to throw down a restoration the next day, not having any spells to spare at the time. If they had had the heal skill, they would've been able to diagnose the disease and prevent the other character from accidentally spreading it to a fairly large group of low-level NPCs.

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    \$\begingroup\$ The Technology Guide indicates, with no detail, that Heal can be used to identify drugs or pharmaceuticals, but other than that, Heal is not indicated to be used in the identification or diagnosis of any maladies. Otherwise, I’d heartily agree with you, this would be a good use of the Heal skill. Unfortunately, it seems to me that officially this would fall more under some Knowledge skill (local for humanoid patients, maybe nature for recognizing diseases or venoms from plants or animals). \$\endgroup\$
    – KRyan
    Mar 22, 2017 at 15:35
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    \$\begingroup\$ Many official Pathfinder scenarios and modules seem to disagree with you, @KRyan. I've seen plenty of instances of using the Heal skill as a forensic or diagnosis option, often where spells just won't help. \$\endgroup\$
    – YogoZuno
    Mar 22, 2017 at 19:36
  • \$\begingroup\$ You cant heal something if you dont know what it is, so in a defacto way heal lets you do identify wounds. \$\endgroup\$
    – Drew Major
    Jul 23, 2018 at 4:03

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