Healing in combat

[Galithar]

So it's generally agreed upon, at the very minimum on these forums if not every where, that healing in combat is usually not worth it. Some exceptions exist of course. Healing Word is regarded as extremely useful due to the bonus action cast and ranged effect. It always feels like a waste to heal with a spell like Cure Wounds though. You burn your action to heal an amount that even very low CR creatures can remove in one hit.

If the action economy is always spending one action to negate or remove the effect of less than one action from an enemy it is not worth it. So, what level of healing would make Cure Wounds worth an action in combat? And worth it's spell slot. Even if only situationally valuable.

At level 1 when you get the spell it heals 1d8 + spell casting mod. That's actually a lot at level 1. A Friend ghter is going to have about 12 or 13 HP at that level and the Spell will average healing for 7.5. that's over half of the fighters health in one cast. The problem is that by level 5 that Fighter is going to have around 35 HP and at a level 3 slot you're only averaging 16 healing. Not only do you not want to use your biggest slots on this, but we're now down to averaging less than half of the targets health instead of greater than half. This only gets worse as you continue to level. Each level of spellslot is worth more than the last and every level up the Fighter is gaining health faster than your spell scales.

The question is this: What amount of healing would be worth using you action for? What level of healing would be worth moving in to touch range to cast?
Now obviously this is subjective and situational. But what are those numbers for YOU?

[EggKookoo]

What if cure wounds allowed the target creature to roll a number of its own hit dice equal to the level of the spell slot used to cast it? No Con or caster Ability bonus, but the rolled dice are free and do not come from the recipient's available uses.

[stoutstien]

So it's generally agreed upon, at the very minimum on these forums if not every where, that healing in combat is usually not worth it. Some exceptions exist of course. Healing Word is regarded as extremely useful due to the bonus action cast and ranged effect. It always feels like a waste to heal with a spell like Cure Wounds though. You burn your action to heal an amount that even very low CR creatures can remove in one hit.

If the action economy is always spending one action to negate or remove the effect of less than one action from an enemy it is not worth it. So, what level of healing would make Cure Wounds worth an action in combat? And worth it's spell slot. Even if only situationally valuable.

At level 1 when you get the spell it heals 1d8 + spell casting mod. That's actually a lot at level 1. A Friend ghter is going to have about 12 or 13 HP at that level and the Spell will average healing for 7.5. that's over half of the fighters health in one cast. The problem is that by level 5 that Fighter is going to have around 35 HP and at a level 3 slot you're only averaging 16 healing. Not only do you not want to use your biggest slots on this, but we're now down to averaging less than half of the targets health instead of greater than half. This only gets worse as you continue to level. Each level of spellslot is worth more than the last and every level up the Fighter is gaining health faster than your spell scales.

The question is this: What amount of healing would be worth using you action for? What level of healing would be worth moving in to touch range to cast?
Now obviously this is subjective and situational. But what are those numbers for YOU?

something i've done in the past is change cure wound from 1d8 into 2d4 with 2d4 scaling per LV. it becomes a slightly better spell when you know that the average and minimum amounts healed are better. i've also thought about adding a small rider effect to cure wounds but haven't found one i like.

[BurgerBeast]

Perhaps the problem is not that healing is underpwered, per se. Perhaps the problem is that every other spell, when compared to healing word, is underpowered.

The pampering death and dying mechanics, and the pop-up healing phenomenon that results from it, are more likely to be the true underlying problem, in my opinion.

I’m not saying that they should be a thing, but if they were a thing, negative hit points could make healing word less powerful. Similarly, if there was no dying status from which a single hit point could save someone, things like laying on hands, goodberries (not even getting into the ability to feed them to unconscious characters), etc would be less “gamey.”

[stoutstien]

Perhaps the problem is not that healing is underpwered, per se. Perhaps the problem is that every other spell, when compared to healing word, is underpowered.

The pampering death and dying mechanics, and the pop-up healing phenomenon that results from it, are more likely to be the true underlying problem, in my opinion.

I’m not saying that they should be a thing, but if they were a thing, negative hit points could make healing word less powerful. Similarly, if there was no dying status from which a single hit point could save someone, things like laying on hands, goodberries (not even getting into the ability to feed them to unconscious characters), etc would be less “gamey.”

cure wounds still sucks if you avoid wack-a-mole healing question. it doesn't scale to heal a big enough % of the PC's HP after the first few levels. even if you auto maxed the healing of the spell it loses steam. a level 9 slot cure wound barely heals up a lv 10 monk with +2 con IF the dice are maximized.

[Anymage]

I don't know that the problem with Cure Wounds is a problem with healing in general, so much as it's a problem with the way that upcasting in general peters out. Heal's 70 HP are a sizable chunk of an 11th level fighter's HP, and the fact that a sixth level Cure Wounds only heals about half of that shouldn't be more surprising than the fact that third level standout Fireball isn't slot-competitive if cast from a ninth level slot.

Pop up healing is admittedly a thing this system turned into an issue, but it's hard to work around that without letting stray crits creep into instakill territory.

[jas61292]

I think that if you want healing spells to be seen as a good action in combat, they need to be around as effective as damaging spells. While it certainly doesn't have to be a one to one match, when you look at it now, until you get to Heal at 6th level, it doesn't come even close to comparing.

Looking at first level slots, assuming a casting stat of 16 but no special bonuses, Cure Wounds heals an average of 7.5. Now that doesn't sound too awful necessarily. On the offensive side of thing, Chromatic Orb averages 13.5 damage, but has to hit first. That means they are about equivalent at an accuracy of 55%. That's lower than the normal accuracy I'd assume, but not ridiculous. However, not only is Chromatic Orb average better in most normal situations, but it is also a ranged option and has some built in versatility.

For a comparison of something that doesn't miss, you have Magic Missile, which as a level one spell does an average of 10.5 damage. Straight up better than what Cure Wounds heals. And once again while Cure Wounds has no versatility or range, Magic Missile has long range and can spread around damage if you want.

If instead you want to compare to something without versatility or range, you have Cure Wound's negative energy counterpart: Inflict Wounds. Once again though the damage will be coming out on top. At 3d10, Inflict averages 16.5 damage on a hit, meaning an enemy's AC would have to be high enough to give the attack 45% accuracy before the healing matches the damage. That's not good

And then, to make things worse, you have things like Burning Hands. 10.5 damage, on average, to multiple targets, while still doing half on a save. If more than one creature is in the area, it will be dealing more than Cure Wounds heals even if both make the save. Cure Wounds simply cannot compare, and there is no multi target alternative.

Heck, by the time multi target healing does come online the comparison is arguably even more embarrassing. Mass Healing Word is a third level spell. It heals up to 6 people for an average of 6.5 damage, assuming our healer boosted their casting stat to an 18 at 4th level. That is hilariously bad. With the same level spell, that enemy sorcerer just threw a Fireball that did an average of 28 damage to everyone in a large area. Sure, Mass Healing Word has the action economy advantage, but it would still take casting it more than 4 times on average to undo what one spell of the same level does.

I'm not going to keep going over every single comparison, but fact is, until you get to Heal at 6th level, the comparisons are just never even close. If healing is to be valuable in combat, then it has to keep pace with the damage that is being dealt. While any healing that keeps someone up who would have gone down is worth it, the only way to be sure of that is if you are healing for around as much as an enemy can do, essentially undoing and "wasting" their action. And the best way to measure that is to make it comparable to what offensive spells can do. While offensive options typically can miss or be saved against, meaning that the absolute number of dice healed does not neat to match the exact damage dice, it needs to be a lot closer than it is, especially when it comes to group healing. Multi target healing should be available much earlier, and should actually heal a decent amount. If that was actually the case in combat healing would be considered totally viable, without the need for being totally dedicated to it. At the same time, so long as it is not outright better than what damaging spells can do, it would keep from being seen as a necessary or dominant strategy.


Edit: I just realized that what makes all this worse is the the DMG itself has guidelines for creating spells. It has a table of how much damage spells of a given level should tend to do, and then says straight up that, other than cantrips (which should not heal), healing should use the same dice as damage. That's even more powerful that what I'm suggesting, and I find that hilarious as no existing spells below Heal come even remotely close to the guidelines. I mean, it suggests a muti target heal of 5th level should heal 8d6 damage, or 28, when in reality you got Mass Cure Wounds which does 3d8+Mod, or 16.5-18.5 depending on ability score. That's just sad.

[stoutstien]

what cure wounds/mass cure wounds need a rider that gives it a reason to cast on top of the hp recovery. maybe add the sanctuary effect to them but limit it to only last until the end of the caster's next turn. or SoFs AC bonus for a round.

[Trustypeaches]

What if Cure Wounds gained 2d8 for each spell level above 1st?

[J-H]

I don't know about the exact # you're looking for, but as a DM for a combat-focused campaign with some tough encounters, I can say that in-combat healing is absolutely necessary to prevent a TPK some of the time. Even a barbarian can run out of hit points quickly when there are multiple casters on the field. My table experience is that the optimization trope of inefficient in-combat healing being a waste of time is a holdover from 3.5.

Pop-up healing can leave characters at a disadvantage, ie losing Rage and Concentration spells. My players have generally tried to avoid it.
On the other hand, everyone still remembers the time the sorcerer went to 0hp about 6 times in 1 fight. He kept hitting the hydra will fire spells, and it kept hitting him with its poison breath.

[Sigreid]

It really depends. If the character getting hit has an AC that means he's getting hit every round for the amount of the heal, you are just spending resources to get nowhere. If, however; the target of attack has sufficient ac or other means of mitigation that he's getting hit 50% or less of the time (or 50% or less of your heal) then your heal is a net gain as 1 action keeps him in the fight for 2 or more additional rounds.

The wack-a-mole style healing doesn't work so well in the game I'm in as the opponent will definitely either strike again to try to finish you before the healer's turn (especially if they've seen this trick before) or use their object interaction to separate you from your weapon and move away from you.

[stoutstien]

It really depends. If the character getting hit has an AC that means he's getting hit every round for the amount of the heal, you are just spending resources to get nowhere. If, however; the target of attack has sufficient ac or other means of mitigation that he's getting hit 50% or less of the time (or 50% or less of your heal) then your heal is a net gain as 1 action keeps him in the fight for 2 or more additional rounds.

The wack-a-mole style healing doesn't work so well in the game I'm in as the opponent will definitely either strike again to try to finish you before the healer's turn (especially if they've seen this trick before) or use their object interaction to separate you from your weapon and move away from you.

the problem is that HP and damage out scale most healing options by such a large margin it is a net loss. dream/shepherd druids can pull it off a few times a day but its not due to healing 'spells'. the bog standard cure wounds never heals enough to be worth it past the first few levels of play even maximized.

[Tanarii]

Comparisons to an allies hit point maximum are flawed. What matters is how many enemy turns you negate per casting. You need to compare the casters HPR to enemy DPR against the target being healed.

[Samayu]

I'm playing a cleric right now. I cast healing spells all the time, but I don't think I've ever used one on a character that had more than zero hit points. Of course it helps that I'm a grave cleric.

When would I consider casting a healing spell in combat? Without considering the grave cleric boost, I would have to be certain I could keep the player up for at least one more round. When enemies are dropping 20 or 30 points of damage per round, what level Cure Wounds would I have to cast? Fifth level, if I rolled average on my d8's, to heal 23 HP. At 12th level, I can assure you I have better uses for a fifth level spell slot that keeping my fighter in the combat for one more round.

Funny though. We're arguing the efficacy of healing spells, when it's clear that a party with a healer has a much greater chance of survival than one without. I think we could reduce the annoyance of pop-up healing by increasing the power of standing-healing.

[Garfunion]

What if cure wounds allowed the target creature to roll a number of its own hit dice equal to the level of the spell slot used to cast it? No Con or caster Ability bonus, but the rolled dice are free and do not come from the recipient's available uses.

This is how most healing spells should have worked. They should have the target spend hit die to heal.

[Pex]

To be worth the action and spell slot a healing spell needs to heal minimum 25% more than the average damage a spell of equal level of the same class list could do. When the healing can heal multiple people then the benchmark is a spell of equal level that can harm multiple people.

The healing power of Healing Word is still garbage. What makes it worth it is the action economy efficiency. The caster doesn't have to move or can move elsewhere from the recipient because it's range, and the bonus action means the caster can do something else important even if only a cantrip since cantrips are significant.

Of course save a party member from dying. If you have to use Cure Wounds do it, but the party as a whole is better off if you use Healing Word and do Something Else.

[Zetakya]

What really make Healing Spells worth it are the various riders and extras that some (sub)classes can layer onto them.

[Kane0]

What if cure wounds allowed the target creature to roll a number of its own hit dice equal to the level of the spell slot used to cast it? No Con or caster Ability bonus, but the rolled dice are free and do not come from the recipient's available uses.

I do this. When you are subject to a Cure Wounds spell you can choose to spend a number of Hit Die equal to the level of the spell to heal yourself further.
But I also add another d8 of healing as part of the spell, so it's 2d8 + Mod at 1st plus another d8 for each level above.

[Addaran]

The very rare times it's worth it is when you want someone holding concentration on a very important spell to stay conscious. Our divine soul sorcerer was grappling a stone golem with telekinesis and had received damage from minions. He used something like a 4th level cure wounds to make sure he stayed conscious.

[stoutstien]

The very rare times it's worth it is when you want someone holding concentration on a very important spell to stay conscious. Our divine soul sorcerer was grappling a stone golem with telekinesis and had received damage from minions. He used something like a 4th level cure wounds to make sure he stayed conscious.

'm more curious how they maintained concentration while being hit my multiple attacks.

[Trustypeaches]

'm more curious how they maintained concentration while being hit my multiple attacks.
They are a Sorcerer, so proficiency in Con saves. They may have also taken War Caster on top of that, or just have a nice juicy high CON.

[stoutstien]

They are a Sorcerer, so proficiency in Con saves. They may have also taken War Caster on top of that, or just have a nice juicy high CON.

even then it is still a risk when there are countless ways to protect the sorcerer from the attacks all together. sanctuary springs to mind.

[MaxWilson]

I don't know about the exact # you're looking for, but as a DM for a combat-focused campaign with some tough encounters, I can say that in-combat healing is absolutely necessary to prevent a TPK some of the time.

I just want to jump in quickly and note that Lesser Restoration is a healing spell which ends paralyzation, and which is sometimes absolutely the difference between death and survival of a PC.

[BurgerBeast]

I think the idea that healing “can’t keep up” is an intentional design choice to balance the use of hit dice for self-healing during rests. Ideally the party doesn’t need in-combat healing. In a pinch, healing word can save someone. Out of combat, in general you use your hit dice but if one or two players is out, the cleric can bust a heal or two to bring them up, in which case why not use a full-round cast for a few extra points.

[EggKookoo]

I do this. When you are subject to a Cure Wounds spell you can choose to spend a number of Hit Die equal to the level of the spell to heal yourself further.
But I also add another d8 of healing as part of the spell, so it's 2d8 + Mod at 1st plus another d8 for each level above.

Out of curiosity, does the target actually spend their hit dice doing this, or those uses free when they're prompted by the spell?

[sithlordnergal]

So, there are a few issues with combat healing:

- Obviously there's the pop-up nature of 5e. A creature with 1 hit point is just as effective as a creature with 100, meaning you can usually save your healing until a party member is down. Because unless that party member is concentrating on something really, really important, it won't matter if they go down.

- Healing Word is the best combat healing spell in the game because of the previously mentioned pop-up nature of 5e. Its a bonus action and can be used at range. As a result, every other healing spell is compared to Healing Word. Doesn't matter if its Cure Wounds or Heal, both spells are compared to Healing Word when the time comes for the Cleric to cast a healing spell.

- The best way to mitigate damage is to incapacitate whoever is attacking. This could be through killing an enemy, or incapacitating them in some non-lethal manner. Either way, if you aren't getting damaged, then there's no need to heal.

- Outside of levels 1 to 3, damage far outstrips anything healing can do. Even as early as level 5, NPC damage starts to get to the point where trying to out-heal whatever you've taken just isn't an option. And heck, I'll prove it:

Lets say you have a 5th level Life Cleric. They put their ASI into Wisdom, so its currently an 18, and they've cast Beacon of Hope to maximize any healing they do. A 3rd level Cure Wounds will heal 33 points of damage with that kind of prep. Now, lets snag some random CR 5 monsters. How about a Fire Elemental, Hill Giant, Vampire Spawn, and Otyugh. I'll only be taking average damage for these calculations.


The Fire Elemental has two attacks, both do an average of 10 damage, so that's 20 points of damage there. But the fire elemental can stand in your spot, dealing an extra 5 points of damage, bringing the total to 25. And finally, you're set on fire, and unless someone puts it out for you with their action, you'll take another 5 damage at the start of your turn for a total of 30 damage. If you choose to then attack the Elemental, it will do an additional 5 points of damage if you're within 5 feet of it when you make the attack. So it can potentially do 35 points of damage to you between its turn and yours, negating the 33 from the Cure Wounds.


The Hill Giant has two Greatclub attacks, both do 18 points of damage for a total of 36. It takes one round to undo the healing from before.


The vampire spawn has two attacks, one that deals 6, and one that deals 13. However, that's a bit deceptive, cause you can't heal 7 of that 13 points of damage since it lowers your Max HP. So while you may only be taking 19 damage, in reality you're taking 12 points of heal-able damage, and 7 points of unfixable damage. It takes three rounds to undo the healing from before, but you also lose 21 HP that can't be healed for the encounter...which kind of evens out the low damage.


An Otyugh has 3 attacks that do 12 and 11 damage respectively. It can only do the 12 damaging attack once, so you get a total of 34 points of damage in one round. It took one round to undo the healing from before.


I can continue and grab other CR 5 monsters, but there's a very clear trend. Outside of the Vampire Spawn and Fire elemental, most CR 5 creatures can do enough damage with a single round of attacks to completely undo that super powered, 3rd level, max healing Cure Wounds. And those monsters can do it every round, where as the Cleric can do that kind of healing once per long rest. And even then both the Vampire Spawn and Fire Elemental have enough gimmicks to make up for their lack of damage. A properly placed Fire Elemental can do more damage then the cure wounds can heal in one round, while the Vampire Spawn basically erases HP, making it impossible to heal whatever was lost without a long rest or Greater Restoration.

[MaxWilson]

Out of curiosity, does the target actually spend their hit dice doing this, or those uses free when they're prompted by the spell?

I thought "spend" was pretty indicative that the hit die gets spent.


So, there are a few issues with combat healing:

- Obviously there's the pop-up nature of 5e. A creature with 1 hit point is just as effective as a creature with 100, meaning you can usually save your healing until a party member is down. Because unless that party member is concentrating on something really, really important, it won't matter if they go down.

- Healing Word is the best combat healing spell in the game because of the previously mentioned pop-up nature of 5e. Its a bonus action and can be used at range. As a result, every other healing spell is compared to Healing Word. Doesn't matter if its Cure Wounds or Heal, both spells are compared to Healing Word when the time comes for the Cleric to cast a healing spell.

I feel that people overestimate how important bonus action spells on a full caster are. It's not like you can cast another spell that round anyway. On a warrior, sure, getting to bonus action (e.g. Expeditious Retreat) and still get off a full Attack + Extra Attacks is great. But on a spellcaster if often just means you get to deal miniscule damage with a cantrip.

Aura of Vitality is a much better combat healing spell than Healing Word in that (1) it gives you a bonus action healing spell that doesn't interfere with spellcasting, and (2) you can leave it running after combat to top everybody off, especially if you Extended it.

[EggKookoo]

I thought "spend" was pretty indicative that the hit die gets spent.

Lighten up, Francis.

I asked because he was responding to my post with "I do this," but I explicitly say in my suggestion that the hit dice were free. Just wanting clarification. I actually think I like the spend idea better.

[MaxWilson]

Lighten up, Francis.

Sorry, didn't mean to be rude. I was simply amused by the redundant question.

[EggKookoo]

Sorry, didn't mean to be rude. I was simply amused by the redundant question.

It's all good, I probably could have taken a breath before posting as well.

[sithlordnergal]

I thought "spend" was pretty indicative that the hit die gets spent.



I feel that people overestimate how important bonus action spells on a full caster are. It's not like you can cast another spell that round anyway. On a warrior, sure, getting to bonus action (e.g. Expeditious Retreat) and still get off a full Attack + Extra Attacks is great. But on a spellcaster if often just means you get to deal miniscule damage with a cantrip.

Aura of Vitality is a much better combat healing spell than Healing Word in that (1) it gives you a bonus action healing spell that doesn't interfere with spellcasting, and (2) you can leave it running after combat to top everybody off, especially if you Extended it.

Yes, but Healing Word is still better than Cure Wounds, and can be better then the Heal spell because Healing Word is a bonus action, and most other healing spells are actions. Because lets be honest, which is better? Bringing someone up from 0 and potentially doing between 1d8 to 4d8 damage in a round, or just bringing someone up from 0.

And while Aura of Vitality is actually far better then Healing Word in a lot of ways, it has two major downsides that cause it to be worse:

1) It is a Paladin spell.

2) It is a 3rd level Paladin spell.

So unless you're a Lore Bard and snag it as one of your Magical Secrets, that spell doesn't come into play until level 9. And even then it may not see play because it is competing with something far stronger then it, 3rd level smites.

[Dork_Forge]

I don't think there's really a problem with healing in combat, I think the problem lies with peoples views and expectations (I've never seen in another game nor been in or ran a game where a newbie thought healing was lack lustre):

Cure Wounds is just fine, if it isn't the go to healing spell after level 3 or 4 that's OKAY it's a 1st level spell. Upcasting spells is rarely worth it for scaling effects that aren't just targeting more creatures (4th level slot for another d6 on Fireball?). As you level up you should move on to higher level spells, if the subsequent complaint is there isn't a good enough healing spell at 2nd or 3rd level then okay brew up a Heal Greater Wounds, personally never had that problem.

If you're experiencing this problem as a healer, then you may not be using your kit to it's fullest or built the best for healing, there's plenty of healing abilities that take it to 11 (Shepherd's aura, most of the Life Cleric kit etc.). If you're experiencing this as a half caster using Cure Wounds, a Magic Initiate or dipper, then readjust what you can expect.

On whack a mole healing, personally I hate it both fluff wise (you're going to let your companion start to die before you bother healing them, really?) and as a player. That character could lose a turn, lose resources etc. that cost the party and make the encounter unnecessarily harder. As a DM I look at the healing capability of a party when I throw an encounter at them, if they don't actually burn their healing then playing whack a mole quickly turns into a death spiral straight to a TPK.

[Tanarii]

To be worth the action and spell slot a healing spell needs to heal minimum 25% more than the average damage a spell of equal level of the same class list could do. When the healing can heal multiple people then the benchmark is a spell of equal level that can harm multiple people.
What is this based on?

Remember, you're comparing the healing power HPR to both spell DPR and enemy DPR. And the chance of healing is 100%.

On the spell damage comparison, the chance of applying any other spells damage is reduced by enemy defenses. Either a saving throw or AC. Those spells are not 100% effective. Typically they are about 75% effective (save for half with 50% chance of save) or 65% effective (attack roll against AC).

Meanwhile the damAge your negating, the enemy turns negated is enemy DPR. Not damage on hit, damage times chance of hit. That's a mistake multiple posters have made in this thread.

So where are the numbers to show that to be effective, taking into account enemyDPR and spell DPR, the number of enemy round negated is roughly equal to the shorted number of rounds of the fight by using a spell = to x1.25 spellbase damage?

That number doesn't have to be > damage inflicted on a hit. In fact, my gut tells me it should be considerably less than that number.

[Addaran]

even then it is still a risk when there are countless ways to protect the sorcerer from the attacks all together. sanctuary springs to mind.

It was always small attacks that did under 20 damage. He does have good con and proficiency and rolled decently.
I though sanctuary was concentration. But he doesn't know it and DM would probably rule that "attacking" with telekinesis breaks it.

[MaxWilson]

On whack a mole healing, personally I hate it both fluff wise (you're going to let your companion start to die before you bother healing them, really?)

To be fair, there *are* plenty of people out there who interpret HP in such a way that until you hit zero HP you haven't actually been injured, which makes not healing them yet 100% reasonable from an in-character perspective.

[stoutstien]

It was always small attacks that did under 20 damage. He does have good con and proficiency and rolled decently.
I though sanctuary was concentration. But he doesn't know it and DM would probably rule that "attacking" with telekinesis breaks it.

Sanctuary is overlooked a lot.
Telekinesis is definitely not an attack nor does it does damage unless you Drop something or someone with it.

[MaxWilson]

It was always small attacks that did under 20 damage. He does have good con and proficiency and rolled decently.
I though sanctuary was concentration. But he doesn't know it and DM would probably rule that "attacking" with telekinesis breaks it.

Encourage him to learn it next time he levels up.

[Pex]

The very rare times it's worth it is when you want someone holding concentration on a very important spell to stay conscious. Our divine soul sorcerer was grappling a stone golem with telekinesis and had received damage from minions. He used something like a 4th level cure wounds to make sure he stayed conscious.

Nodding my head.


I thought "spend" was pretty indicative that the hit die gets spent.



I feel that people overestimate how important bonus action spells on a full caster are. It's not like you can cast another spell that round anyway. On a warrior, sure, getting to bonus action (e.g. Expeditious Retreat) and still get off a full Attack + Extra Attacks is great. But on a spellcaster if often just means you get to deal miniscule damage with a cantrip.

Aura of Vitality is a much better combat healing spell than Healing Word in that (1) it gives you a bonus action healing spell that doesn't interfere with spellcasting, and (2) you can leave it running after combat to top everybody off, especially if you Extended it.

At 5th level Sacred Flame does 2d8 damage. Toll the Dead is 2d12. Cure Wounds heals 1d8 + 4, given 18 WI. A Cantrip deals at least as much damage as you heal. If you heal someone the enemy is not taking the damage. If you cast Healing Word you still heal someone, if not as much, and the enemy takes the damage.

At 8th level, presuming bumping WI to 20, Cure Wounds heals 1d8 + 5. Sacred Flame for the spellcasting focused cleric deals 2d8 + 5 damage. Toll the Dead is 2d12 + 5. The Cantrips are now doing a full die of damage more than you heal.

Maybe instead the cleric has previously cast a Concentration spell. Bless. Bane. Spirit Guardians. He really wants to keep that spell. He can cast Cure Wounds and hope for the best. Alternatively, he can cast Healing Word then for his action Dodge making him harder to hit. Maybe after he casts Healing Word, or even before Healing Word, he needs to take the Disengage Action and move away from the enemy next to him.

Aura of Vitality is a Paladin spell. It's not an option others can have except Bard through magical secrets, unless you use an Unearthed Arcana reference. It's a 3rd level spell. It should be better than Healing Word, but it isn't capable of being cast as often. Still, it's a bonus action to do the healing. Great. Use it then smite the enemy, Paladin. Excellent. That's much better for the Paladin to do than cast Cure Wounds on someone during combat.

[Dork_Forge]

To be fair, there *are* plenty of people out there who interpret HP in such a way that until you hit zero HP you haven't actually been injured, which makes not healing them yet 100% reasonable from an in-character perspective.

That may work for them and hit points aren't meant to just be how damaged you are, but not only is being up and uninjured one moment then bleeding to death the next rather jarring it clashes with how things are actually worded in the game. If you lose 90% of your hp and then regain some from a spell called Cure Wounds I find it difficult to resolve that as "I'm fine really, just winded." Even if they don't consider it real injuries the fact remains that HP is a resource that counts down to your death or near death, so however the want to resolve healing they're still willingly not preventing that near death and very real increased chance of death of who is meant to be a close comrade.

I imagine outside of a Zealot Barbarian whack a mole healing strategies must lead to some frosty carriage rides afterwards if the players were to actual roleplay the situation of "I could have stopped you from nearly dying in the first place, but decided it was more tactical of me to disregard your humanity until it most inconvenienced the group."

Personally whenever I've encountered this kind of player behaviour I've reinforced the reality of nearly dying repeatedly with a level of exhaustion each time a PC goes down. If they only go down once then a short rest will alleviate them of it, if more than once then the exhaustion is treated as normal. I've also used this with groups that don't whack a mole just to increase tension and investment in their characters, it worked wonderfully.

[Pex]

What is this based on?

Remember, you're comparing the healing power HPR to both spell DPR and enemy DPR. And the chance of healing is 100%.

On the spell damage comparison, the chance of applying any other spells damage is reduced by enemy defenses. Either a saving throw or AC. Those spells are not 100% effective. Typically they are about 75% effective (save for half with 50% chance of save) or 65% effective (attack roll against AC).

Meanwhile the damAge your negating, the enemy turns negated is enemy DPR. Not damage on hit, damage times chance of hit. That's a mistake multiple posters have made in this thread.

So where are the numbers to show that to be effective, taking into account enemyDPR and spell DPR, the number of enemy round negated is roughly equal to the shorted number of rounds of the fight by using a spell = to x1.25 spellbase damage?

That number doesn't have to be > damage inflicted on a hit. In fact, my gut tells me it should be considerably less than that number.

It's based on my personal opinion of the matter which is what was asked. When is a healing spell worth the spell slot and action to use it. Since it doesn't exist, except perhaps Heal, Mass Heal, Power Word Heal, Polymorph :smallyuk:, I'm quite willing to accept Healing Word despite its garbage healing power because of the action economy it allows when healing power is needed to save someone. If someone has to use their Action for healing, for whatever reason, I'd rather they cast Spare The Dying (or use a healing kit) and save the spell slot for a more potent spell next round. If it's a desperate situation I'm not going to cry over someone casting Cure Wounds and be happy a fellow PC or even my character was saved from death; it's just not my go to preference as standard operation procedure.

[Tanarii]

To be worth the spell slot and action, all it has to do is heal more (at 100% value) than damage of the comparison spell accounting for hit chance/save, divided by enemy max hit points, times enemy DPR against the target they'd attack. That's how much damage you're preventing by damaging the enemy. That's how much damage the spell should be set to heal, in terms of system math.

In terms of actual use of course, circumstances may vary. If you can't take out an enemy a round earlier by damage but can raise hit points just enough to prevent a hit from taking an ally down to 0, it's definitely worth it. And if you can take out an enemy one round early by using a damaging spell but cannot heal enough to prevent drop to 0, it's definitely worth using the damaging spell.

[iTreeby]

Healing doesn't take you closer to winning. Healing is only worth an action if you can heal more than the enemy is damaging in a turn.

[Tanarii]

Healing doesn't take you closer to winning. Healing is only worth an action if you can heal more than the enemy is damaging in a turn.
This is exactly the kind of mistake I've been talking about.

[iTreeby]

This is exactly the kind of mistake I've been talking about.

You can heal one thousand damage every turn and never win. Healing doesn't bring you closer to the objective of damaging an enemy. It can generate an action advantage if it takes the enemy more turns to damage than it does for you to heal a given amount but it's probably still better to attack.

[MaxWilson]

To be worth the spell slot and action, all it has to do is heal more (at 100% value) than damage of the comparison spell accounting for hit chance/save, divided by enemy max hit points, times enemy DPR against the target they'd attack. That's how much damage you're preventing by damaging the enemy. That's how much damage the spell should be set to heal, in terms of system math.

Don't you also have to account for the number of rounds the enemy would otherwise live?

If you're fighting half a dozen Orogs, each of which is doing about 10 DPR to the party, and the party is killing about one Orog per round, the party will take about 60 + 50 + 40 + 30 + 20 + 10 = 210 damage before the combat is over. But if you nova hard at the beginning and kill one Orog immediately, they'll only take 50 + 40 + 30 + 20 + 10 = 150 damage. You're not just saving 10 HP by killing one Orog immediately, you're saving 60. That's what the healing spell has to compete with.

But if there were only 2 Orogs you'd only be saving 20 HP.

[Gungor]

While I agree that on average, in-combat healing isn't the best use of action/spell slot, it can be extremely useful in a number of situations:

1. Healing an ally who has a valuable buff going, which would go away if they dropped to 0 hit points. This could be a concentration spell but could also be a spiritual weapon, a wild-shaped druid, or someone controlling a bunch of minions.

2. When healing a raging barbarian, it effectively doubles the effectiveness (in some situations) because of damage resistance.

3. This is a admittedly meta-gamey, but if you can bring the fighter's HP total high enough to just stay up through the next BBEG's attack, then the fighter will be conscious to get their attack, use action surge, take second wind, etc. This could be the thing that turns the tide of the battle.

To me, a bigger issue is that many clerics feel it is necessary to have both healing word AND cure wounds prepared to ensure they have their bases covered. So there's a "spells prepared" tax. In fact, in most games I've played everyone who has access to the spell feels like they need to have it just in case, so I've seen situations where the bard, cleric, and druid are all carrying Cure Wounds around.

[col_impact]

Healing in combat sucks unless you are a Shepherd Druid. In the case instance you are a Shepherd, then you are . . . god of healing. <<Play arcade sounds of cascading rewards>>

[stoutstien]

Anyone curious enough to want to compare healing during combat compared to other options?
Let's say we have a level 4 party and use the pre-generated characters from The starting set.
The party is fighting X amount of gnolls. Gnolls are nice because the have a pretty good built in reason to avoid going to zero HP.(on a side tangent that's actually a really good idea to add to some NPCs. Image a NPC that healed a solid chunk Everytime it attacks someone and they fall to zero HP.)
How many gnolls attacking the fighter would mean that:
Cure wounds is best
Shield of faith is best
Spiritual weapon is best
Warding bond is best
Healing word is best

Just off the hip I think SoF would win with 6 gnolls but SW would win with 4.

[col_impact]

Anyone curious enough to want to compare healing during combat compared to other options?
Let's say we have a level 4 party and use the pre-generated characters from The starting set.
The party is fighting X amount of gnolls. Gnolls are nice because the have a pretty good built in reason to avoid going to zero HP.(on a side tangent that's actually a really good idea to add to some NPCs. Image a NPC that healed a solid chunk Everytime it attacks someone and they fall to zero HP.)
How many gnolls attacking the fighter would mean that:
Cure wounds is best
Shield of faith is best
Spiritual weapon is best
Warding bond is best
Healing word is best

Just off the hip I think SoF would win with 6 gnolls but SW would win with 4.

Healing Word is best in this scenario. Give my regards to the fallen.

[Corran]

Anyone curious enough to want to compare healing during combat compared to other options?
Let's say we have a level 4 party and use the pre-generated characters from The starting set.
The party is fighting X amount of gnolls. Gnolls are nice because the have a pretty good built in reason to avoid going to zero HP.(on a side tangent that's actually a really good idea to add to some NPCs. Image a NPC that healed a solid chunk Everytime it attacks someone and they fall to zero HP.)
How many gnolls attacking the fighter would mean that:
Cure wounds is best
Shield of faith is best
Spiritual weapon is best
Warding bond is best
Healing word is best

Just off the hip I think SoF would win with 6 gnolls but SW would win with 4.
Probably off topic, since the thread is about healing in combat, but
while thinking of your problem, it occurred to me that cost-effective out of combat healing changes drastically how we approach solving problems like that. Because 'winning most effectively on average' can be different to 'risking as little as possible to suffer defeat'. So for example, while shield of faith is better than spiritual weapon when X gnolls target the fighter (with the risk of losing concentration approximated and included in the calculation), having a good amount of goodberries from the day before, could be enough to make spiritual weapon the better choice. Because even if you are not winning as well on average as with shield of faith, all you are really interested about is to minimize the risk of defeat (and it's possible that spiritual weapon does that better than shield of faith). As I said, not really relevant to the topic, but I thought this was an interesting idea and I wanted to share it.

[stoutstien]

Probably off topic, since the thread is about healing in combat, but
while thinking of your problem, it occurred to me that cost-effective out of combat healing changes drastically how we approach solving problems like that. Because 'winning most effectively on average' is different to 'risking as little as possible to suffer defeat'. So for example, while shield of faith is better than spiritual weapon when X gnolls target the fighter (with the risk of losing concentration approximated and included in the calculation), having a good amount of goodberries from the day before, could be enough to make spiritual weapon the better choice. Because even if you are not winning as well on average as with shield of faith, all you are really interested about is to minimize the risk of defeat (and it's possible that spiritual weapon does that better than shield of faith). As I said, not really relevant to the topic, but I thought this was an interesting idea and I wanted to share it.


Not off topic really but I'm holding off comparing success as efficients as possible and not losing being conservative until after a good idea of a single encounter looks. After that you could make a few different encounters and build a mock adventuring day.

Though. with the starter set party there's no goodberrys to work with lol.

I've done it in the past to see how parties would do generally giving different encounter and recovery patterns but I've never looked exclusively at healing.

[col_impact]

Glad you think goodberry and healing word are top picks. Also, I am glad you love my builds.

[Zetakya]

The most effective healing is of course temporary HP, as it is effectively healing that you've done in advance.

[Pex]

Healing in combat sucks unless you are a Shepherd Druid. In the case instance you are a Shepherd, then you are . . . god of healing. <<Play arcade sounds of cascading rewards>>

Arcana Cleric has a good incentive too since their healing spells become dispel magic spells. Healing Word is still better for the action economy, but dispelling harmful spell effects is a worthwhile thing adding more healing power with Cure Wounds is fine.

[stoutstien]

The most effective healing is of course temporary HP, as it is effectively healing that you've done in advance.

THP is a different animal. A while back I compounded a list of all the ways players can generate it I need to update it with ERLW content but it's still mostly relevant.

I agree that having a reliable source of THP is ideal but it's also why I chose the pre-generated starter PCs because they would represent a party without much focus on extras like THP.
Would have aid available though so I'll factor that.

[Tanarii]

Don't you also have to account for the number of rounds the enemy would otherwise live?

If you're fighting half a dozen Orogs, each of which is doing about 10 DPR to the party, and the party is killing about one Orog per round, the party will take about 60 + 50 + 40 + 30 + 20 + 10 = 210 damage before the combat is over. But if you nova hard at the beginning and kill one Orog immediately, they'll only take 50 + 40 + 30 + 20 + 10 = 150 damage. You're not just saving 10 HP by killing one Orog immediately, you're saving 60. That's what the healing spell has to compete with.

But if there were only 2 Orogs you'd only be saving 20 HP.The answer is typically 1 or 0 round-equivalents difference. Because you're comparing one character attacking this round vs healing this round, and one (or more for multi target offensive spells) enemy attacking this round vs not getting to attack this round. It doesn't carry forward.

However there absolutely is a difference between white room DPRs/HPRs and white room examples with HP thresholds build in, let alone simulations or real game play. Exactly because of the 0 HP threshold.


You can heal one thousand damage every turn and never win. Healing doesn't bring you closer to the objective of damaging an enemy. It can generate an action advantage if it takes the enemy more turns to damage than it does for you to heal a given amount but it's probably still better to attack.
You don't have to heal more than the enemy does, you have to heal more than the enemy does relative to your portion of the offensive. Because you have allies also contributing offensively.

[iTreeby]

You don't have to heal more than the enemy does, you have to heal more than the enemy does relative to your portion of the offensive. Because you have allies also contributing offensively.
Youd have one more ally contributing offensively if you stopped healing an did some damage.

A cleric or druid has better options for an action or a spell slot than healing in a combat scenario.

A druid using thunder wave does garenteed damage to at least one enemy. You lose out on that damage if the druid cures wounds instead.

Inflict wounds is a garbage spell but a chance to deal 3d10 is better than healing 1d8 plus change healing.

You are basically saying "but if I heal the rogue this turn, he can deal more damage with his sneak attack" and that can be true unber very specific conditions its almost always better to kill an enemy.

[col_impact]

With a 1 level dip in wizard, goodberry delivery service becomes a thing with familiar and unseen servant. Beep beep.

[P. G. Macer]

Regarding Aura of Vitality, in addition to Paladin, Bard, and UA, if you’re playing in Eberron, the Jorasco Mark of Healing Dragonmarked Halfling adds AoV to your spell list. Just putting another potential source out there.

[MaxWilson]

Regarding Aura of Vitality, in addition to Paladin, Bard, and UA, if you’re playing in Eberron, the Jorasco Mark of Healing Dragonmarked Halfling adds AoV to your spell list. Just putting another potential source out there.

Yeah, Life Cleric 1/Celestial Warlock 2/Divine Soul 3 is extremely fun and ties for best healer in the game, while still getting access to Wish and Quickened Agonizing Repelling Blast. No +Cha bump though and slow (25' move) but otherwise good.

[Trustypeaches]

Yeah, Life Cleric 1/Celestial Warlock 2/Divine Soul 3 is extremely fun and ties for best healer in the game, while still getting access to Wish and Quickened Agonizing Repelling Blast. No +Cha bump though and slow (25' move) but otherwise good.
I still think the best healer in the game is Shepherd Druid with a single level of Life Cleric.

Unicorn Totem remains the cheapest, most efficient method of healing multiple targets and comes online at level 2. No other healing subclass can keep their party yo-yo-ing with a healing word each round. Bear Totem is also a not-insignificant chunk of temp hp, and is great if you can use it when you know you can take a short rest afterwards to get your totem back while benefitting from the temp hp.

Hell, if you use the UA class feature variants, druids even get Aura of Vitality too :)

[MaxWilson]

I still think the best healer in the game is Shepherd Druid with a single level of Life Cleric.

Up until the Healing Spirit v2.0 errata, the best healer in the game was a Life Cleric 1 [Disciple of Life] /Shepherd Druid 3+[Healing Spirit]/Sorcerer 3+[Extended Spell] multiclass. At 7th level could heal 3 x Extended Healing Spirit 20d6+80 (150) + 3 x Extended Healing Spirit III 40d6+100 (240) + Extended Healing Spirit IV 60d6+120 (330) = 1500 HP per long rest at level 7, plus temp HP from Bear Spirit or additional party healing form Unicorn Spirit. Now with the Healing Spirit nerf, even with a Jorasco Life Cleric 1/Sorc 6 using Flexible Casting you can only heal 3 x Cure Wounds d8+4 (8.5) + 4 x Aura of Vitality 40d6+100 (240) + Aura of Vitality IV 40d6+120 (260) = 1245.5 HP per long rest at level 7.

Life Cleric 1/Shepherd Druid X can't match that level of output except in silly scenarios involving repeated AoEs being countered by Healing Word + Unicorn Spirit for dozens of rounds at a time.

[col_impact]

Up until the Healing Spirit v2.0 errata, the best healer in the game was a Life Cleric 1 [Disciple of Life] /Shepherd Druid 3+[Healing Spirit]/Sorcerer 3+[Extended Spell] multiclass. At 7th level could heal 3 x Extended Healing Spirit 20d6+80 (150) + 3 x Extended Healing Spirit III 40d6+100 (240) + Extended Healing Spirit IV 60d6+120 (330) = 1500 HP per long rest at level 7, plus temp HP from Bear Spirit or additional party healing form Unicorn Spirit. Now with the Healing Spirit nerf, even with a Jorasco Life Cleric 1/Sorc 6 using Flexible Casting you can only heal 3 x Cure Wounds d8+4 (8.5) + 4 x Aura of Vitality 40d6+100 (240) + Aura of Vitality IV 40d6+120 (260) = 1245.5 HP per long rest at level 7.

Life Cleric 1/Shepherd Druid X can't match that level of output except in silly scenarios involving repeated AoEs being countered by Healing Word + Unicorn Spirit for dozens of rounds at a time.

You want wizard 17 or druid 17 for Shapechange. Shapechange is thay big a deal. You just have to know the monsters well. Good Tier 4 DMs know what I am talking about.

[MaxWilson]

You want wizard 17 or druid 17 for Shapechange. Shapechange is thay big a deal. You just have to know the monsters well. Good Tier 4 DMs know what I am talking about.

At that point you could just Planar Bind a Radiant Idol and have unlimited at-will healing instead.

[Witty Username]

Since it hasn't been mentioned,
Cure wounds can be useful when the casters bonus action is more valuable. For Example, Spiritual Weapon is most of the time better than a cantrip and past the first round does not prohibit spell casting on the action. Healing Word is more for casters with non-spellcasting relevant actions like good weapon attack options. Either way, pop-up healing is what we have.

[Chaosmancer]

Reading the OP and seeing that the ratio of healing to HP Max seems to be a source of concern got me thinking.

While it can only be used once, the Healer feat heal is better than a Cure Wounds until you can cast Cure Wounds as a 3rd level spell.

Some Basic Numbers:

Cure Wounds
1st - 1d8+3 = 7.5
2nd - 2d8+3 = 11
3rd - 3d8+4 = 16.5
4th - 4d8+4 = 20


Healer Feat
1st 1d6+5 = 8.5
3rd 1d6+7 = 10.5
5th 1d6+9 = 12.5
7th 1d6+11 = 14.5

So, what if we gave all healing spells the same scaling bonus? They additionally heal more equal to the level (number of HD) of the target of the healing.

Then, a 1st level cure wounds spell on a 20th level character is 1d8+25. And 29 healing is still pretty worth it. It doesn't beat out the damage you are taking, but would it help enough for the people who see in-combat healing as too weak?