I recently played a healing/support Cleric from about level 5 to level 16, and my experience taught me several things about healing in combat, besides the fact that it often sucks.

The Problem of Healing in Combat

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1. Healing is often a bad idea in combat because it wastes actions. The less enemies moving, the less damage your party takes, so offense is often greater than defense.

2. Healing in combat is often a bad idea because the amount healed is so low. Cure Light Wounds cures 1d8+1/CL points of damage - fine if your enemy is wielding a longsword and has a Strength of 13, but terrible if your enemy is wielding a greatsword with a Str of 18. Even worse, healing scales incredibly terribly compared with both damaging spells and melee attacks.

3. Healing in combat is often impossible because most healing spells are range "touch."

4. Healing in combat is often terrible because of the almost binary nature between "1 HP, and I'm good to go" and "dead."

5. Random chance is bad for players, and the amount healed in a cure x wounds spell is heavily decided by random chance. Healing 9 damage in a round with a max roll cure light wounds at level 1 is great; healing 2 damage under the same circumstances is awful.

6. The "Cure X Wounds" stops at level 4, going into Heal and Mass Cure X Wounds - Heal being extremely powerful, Mass Cure X wounds healing for piddly amounts.

Math!

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Image isn't displaying in preview, so here's a link: http://imgur.com/LkakTdR

Assuming the spell is an arcane spell doing 1d6 damage per caster level. The bestiary numbers are a reference to the average damage by CR table from the Bestiary.


Referring to point #2, the amount that you can heal with a "cure x wounds" is rapidly outpaced by the amount of damage per round the average encounter will drop on your party.

However, there are several abilities that show how these flaws could be solved:

1. Quick Channel, Close Wounds (Spell Compendium), and Fast Aid are all examples of ways healing can be accomplished without spending standard actions.

2. When the spell Heal comes into play, healing goes from one of the weakest combat options to one of the most potent. At level 11, the average creature should be doing about 50 DPR, while Heal is healing for 110 damage - meaning with one standard action, you can accomplish what an opponent should be accomplishing in two full round actions. This shows us that a lot of the problem is simply the amount healed.

3. The PF Cleric's channel energy AoE heal and the Vitalist's collective healing show us that healing from range is extremely freeing from needing to hustle back and forth across the battle grid in medium armor.

4. The aforementioned Close Wounds as well as the Breath of Life spells show two ways of getting around the binary "1 HP, I'm fine/-1 HP, I'm dying" nature of the hit point system: Allowing either a lethal blow to be blocked or healing to occur after a "fatal" blow has been dealt.

5. Random chance I addressed in my own way: I've been allowing players to "take 6" whenever a healing effect that is calculated in d8's is rolled (i.e. a player who casts cure critical wounds could "take 6" and heal 24+CL instead of 4d8+CL).

6. New spells could be made that scale into high levels.


My Proposed Solution

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With all this in mind, allow me to suggest the following changes to the cure wounds line. All classes that get the original "cure x wounds" receive the new spells at the appropriate levels. The spell Heal and Mass Heal would need to be reworked (probably halving their healing to 5/caster level level), but Breath of Life could stay in as-is.

Cure Wounds I
School: Conjuration (Healing)
Level: alchemist 1, bard 1, cleric/oracle 1, druid 1, inquisitor 1, paladin 1, ranger 1, witch 1
Casting Time: Standard (see text)
Components: V, S
Range: Close (25ft.+5 ft. per two caster levels) (see text)
Target: One ally
Duration: Instantaneous
Saving Throw; Will half (harmless); see text; Spell Resistance: yes (harmless); see text

Sensing the deep pain of an ally, you channel positive energy that cures 1d8 points of damage. Since undead are powered by negative energy, this spell deals damage to them instead of curing their wounds. An undead creature can apply Spell Resistance, and can attempt a Will save to take half damage.

When you cast this spell, you can make a number of choices:

1. When using this spell to cure damage, you can choose to "take 5" when casting this spell. Instead of rolling a d8, simply add 5 to the amount healed.

2. If you cast this spell with a range (touch), add your caster level to the amount healed.

3. You can choose to cast this spell as an immediate action when an ally with range takes damage, but the amount healed drops to 1d4. This healing can prevent an ally from dying. You can choose to "take 3" when using Cure Wounds I in this way. You cannot use this version of cure wounds I to damage an undead creature.

Cure Wounds II
Level: Level alchemist 2, bard 2, cleric/oracle 2, druid 3, inquisitor 2, paladin 2, ranger 2, witch 2; Domain healing 2

This spell functions like cure wounds I, except that it cures 3d8 points of damage.

Cure Wounds III
Level: alchemist 3, bard 3, cleric/oracle 3, druid 4, inquisitor 3, paladin 3, ranger 3, witch 4; Domain healing 3

This spell functions like cure wounds I, except that it cure 5d8 damage.
For the sake of brevity:
Cure Wounds IV - 7d8
Cure Wounds V - 9d8
Cure Wounds VI - 11d8
Cure Wounds VII - 13d8
Cure Wounds VIII - 15d8
Cure Wounds IX - 17d8

Cure Wounds I, Mass
Level: 5
Target: one creature/level, no two of which can be more than 30 ft. apart

This spell functions like cure wounds I, except as above and you always add your caster level to the amount healed, not just when casting the spell with range (touch).

Cure Wounds II, Mass
Level: 6
Target: one creature/level, no two of which can be more than 30 ft. apart

This spell functions like cure wounds II, except as above and you always add your caster level to the amount healed, not just when casting the spell with range (touch).
Brevity again:

Cure Wounds III, Mass - Cleric/Oracle 7
Cure Wounds IV, Mass - Cleric/Oracle 8
Cure Wounds V, Mass - Cleric/Oracle 9


Math and Goals, Revisited

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Again, image doesn't seem to be showing up, so here's the link: http://imgur.com/QV0whvK

It's important to note that 1d6/level spells equal the healing per level spells perfect if they can get just +1 damage per d6 (like Energy Ray, or most psionic damage dealing powers in general).

Let's refer to our original goals:

1. Action economy: The main line of healing spells can now always be used as an immediate action.

2. Raw Healing per Round: Increased at all levels (except, perhaps, level 1) and balanced against expected incoming damage from the average encounter, while also avoiding the extreme over-healing that the Heal spell makes.

3. Range: The main line of healing spells can be cast from range, but provide greater benefit at range of touch.

4. Binary HP: The main line of healing spells can now prevent an ally from death (increasing the window of opportunity that healing is helpful).

5. Randomness: Completely optional with the "take 5" concept baked into the spells.

6. New Spells: Made.


The Next Steps?

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If I was going to add anything else to this concept, it'd probably be more feats for healers. I'd like a feat that includes the primary casting modifier, a feat that allows all cure spells to be used like breath of life, maybe more. Ranks in Heal seem like a good balancing point.


TL;DR: Six things that keep healing in combat from being optimal are the action economy issues, the amount healed compared with incoming damage, the range of healing spells, the binary nature of HP, the randomness inherent in rolling dice, and the fact that new single-target healing spells stop coming after spell level 5. Here's an attempt to fix these things.

Thoughts? Opinions? Hate?