[Basic] Skill of the week: Physician and Physiology

[johndallman]

Physician is the IQ/H TL practical skill of helping the sick and injured and helping them get better by scientific methods. It defaults to IQ-7, First Aid-11 (the second biggest default penalty in RAW), or Veterinary-4; lots of skills default to Physician, including First Aid at unmodified Physician. Skill rolls are used to test general medical competence, and to help people recover from injury and illness (B423). The skill doesn't require specialisation, but physiology modifiers apply for different species.

Physiology is the IQ/H TL scientific skill of detailed biological knowledge about a species, primarily to support medical practice. The defaults are IQ-6, Diagnosis-5, Physician-5 or Surgery-5, and Surgery has a default to Physiology. It requires specialisation by species, and doesn't specify defaults for other species, but the physiology modifiers seem like a good starting point. The GURPS skill clearly encompasses the two related scientific fields of anatomy and physiology, which are often taught separately in medical training.

In many worlds, Physician does not exist at TL1-4, and Pharmacy (Herbal) and/or Esoteric Medicine are used instead. However, some TL4 or earlier worlds do have Physician: Yrth manages it because of its modern influences. At TL5+, a lot of medical knowledge comes under Pharmacy (Synthetic), and doctors know a lot about drugs, and how to apply them. With Physician, you can identify most drugs of your TL (-5 without a laboratory, +3 if you risk smelling or tasting them), but you need Pharmacy to make them. Physiology appears at TL4.

Both these skills date from GURPS 1e, and are boosted by Healer talent. Physician can be a counter to Cyclic attacks that inflict fatigue or toxic damage, can be used to fulfil the Maintenance disadvantage and control Wounded, and is required for full use of Surgery skill. It can also ameliorate critical failures of healing spells, and is hugely important in recovery from injuries and illnesses (B422-444). There's an interesting rule for Physician at TL7+, which has survived since 1e: the skill can operate at TL6 without any special training, provided you have a hygienic working environment.

Bio-Tech, naturally, adds a lot of material about these skills. There are several specific applications for Physiology, and it's a primary skill for the Physician and Forensic Pathologist templates. Physician gets a lot of attention: there are lots of specific tasks and equipment for it, the Medical Treatment flowchart and templates for many kinds of characters connected with medicine. Nurses have Physician as their primary skill, and it's also what anesthetists use. (Physiotherapy) is an optional specialisation, and I reckon physios should not have Empathy: you have to cause pain as part of the job. Suturing seems to be Physician, not Surgery, since nurses do it.

Physician is universal on templates for doctors; Physiology is sometimes neglected outside Bio-Tech. Action has extreme levels of Physician, used to simulate action-movie reality (I found it helpful to be even more extreme) and equipment, including smell-proof body bags, truth serums, drugging people to keep them quiet, and curing cinematic plagues. AtE covers medicine, plagues and injuries; Banestorm has its own plagues, low-tech Physicians, and patron saints. Dungeon Fantasy uses Physiology (monster type) quite a lot. High-Tech has plenty of equipment, and Horror introduces Physician (Psychiatric), for campaigns that deal with madness, defaulting to and from (General) at -4, plus medical procedures such as lobotomy and electroshock therapy; Madness Dossier has Physiology (Irruptor), and personality-altering drugs. Low-Tech has plenty on low-tech Physicians and LTC1 adds hospital organisation, which is well worth having. Magic has spells and magic items to assist Physician, and allows very high skill to substitute for Magery in some cases. Martial Arts has material on Physiology; Gladiators has more on low-tech medicine and Technical Grappling offers Pressure Points defaulting to Physiology. Mysteries has more poisons, and detail on real-world medical examiners. Power-Ups volumes 2, 3, 7 and 8 have examples for these skills. Thaumatology: Alchemical Baroque has a version of Physician/TL4, and Zombies uses Physician or Physiology for inventing ... you guessed!

What have you done with Physician that was weird, cool, or both? Have you used Physiology much?

[ericthered]

As a side note, in the modern world what gurps calls physician is actually done by nurses, with much of what doctors do being diagnosis.

[RogerBW]

Originally Posted by ericthered

As a side note, in the modern world what gurps calls physician is actually done by nurses, with much of what doctors do being diagnosis.

Even so, I have known plenty of doctors who were expert in the things Physician allows (supervising and aiding recovery, selecting and prescribing drugs, general medical competence) except for those covered by First Aid, because a lot of basic first aid procedures get taught once at the start of medical school and then never used again. So at the very least I'd allow modern doctor PCs to consider taking Incompetence (First Aid).

I remember an argument back in the day, maybe on GURPSNET, that Physiology ought to give a bonus in melee because you knew where to hit; that's effectively become Pressure Secrets in 4e.

[malloyd]

Originally Posted by RogerBW

Even so, I have known plenty of doctors who were expert in the things Physician allows (supervising and aiding recovery, selecting and prescribing drugs, general medical competence) except for those covered by First Aid, because a lot of basic first aid procedures get taught once at the start of medical school and then never used again. So at the very least I'd allow modern doctor PCs to consider taking Incompetence (First Aid).

I've seriously considered moving the First Aid default from Physician to Surgery for much that reason, which doesn't exactly solve that RAW (given Surgery defaults to Physician -5) but feels like a step in the right direction.

Anybody whose Physician skill comes from a modern medical training probably should have a point in Surgery anyway, while the hedge wizard whose high Physician skill comes from his mastery of herbal medicine might very well not be able to stop major bleeding or set bones either.

[Celti]

I've just taken for a new character in a Weird War III (alien/demonic invasion) game an optional specialisation of Physiology I hadn't seen mentioned here: Physiology (Combat).

My group has used this in previous games (and will be in this game, of course) as Physiology focused on harming the target species, rather than the more usual therapeutic uses.

[Railstar]

Originally Posted by Celti

I've just taken for a new character in a Weird War III (alien/demonic invasion) game an optional specialisation of Physiology I hadn't seen mentioned here: Physiology (Combat).

My group has used this in previous games (and will be in this game, of course) as Physiology focused on harming the target species, rather than the more usual therapeutic uses.

That is interesting, and certainly consistent with things like the Holy Warrior in DF having Physiology as part of the template. Would you be willing to go into more detail? I've never really seen Physiology being used for harming.

[acrosome]

Originally Posted by malloyd

I've seriously considered moving the First Aid default from Physician to Surgery for much that reason, which doesn't exactly solve that RAW (given Surgery defaults to Physician -5) but feels like a step in the right direction...

I've said this before. (Full disclosure- I'm a general surgeon.) It makes much more sense for First Aid to default from Surgery at -0, and from Physician at something like -2 or more, and Physiology (Human) at (at least) -5.

I could even make an argument for GURPS's only positive default, frankly- something like First Aid defaults to Surgery +2 or whatever- if you want to keep the Physician default at -0. Any higher than +2 and it gets ridiculous, though.

Surgeons make awesome first responders. (When they have access to all of their toys...)

But after TL6 or so Surgery should need mandatory specialization, and this would only really apply to General Surgery, Vascular Surgery, Cardiothoracic Surgery and the other subspecialties of General Surgery. Orthopedics would be a little worse, and other Surgery specialties even more so, though still better than the Physician default. Oh, and there possibly should be something like a Surgery (Emergency Procedures) specialty for ER docs, paramedics, etc. that has the better First Aid default, too. None of them would have it at terribly high levels to begin with, though. You'd definitely rather a surgeon opened your chest in the trauma bay than an ER doc, frex.

[johndallman]

Added to my notes for SotW: Surgery.

[whswhs]

Originally Posted by acrosome

But after TL6 or so Surgery should need mandatory specialization, and this would only really apply to General Surgery, Vascular Surgery, Cardiothoracic Surgery and the other subspecialties of General Surgery. Orthopedics would be a little worse, and other Surgery specialties even more so, though still better than the Physician default. Oh, and there possibly should be something like a Surgery (Emergency Procedures) specialty for ER docs, paramedics, etc. that has the better First Aid default, too. None of them would have it at terribly high levels to begin with, though. You'd definitely rather a surgeon opened your chest in the trauma bay than an ER doc, frex.

In GURPS Low-Tech, there is Surgery (Trauma Surgery), which is one level less difficult and avoids the penalty for undiagnosed conditions (at least most of the time). This probably isn't exactly what you have in mind, if only because it's defined in terms of what, say, a Roman legion's medical specialists could do. But it's related, I think.

[RogerBW]

Originally Posted by acrosome

Oh, and there possibly should be something like a Surgery (Emergency Procedures) specialty for ER docs, paramedics, etc. that has the better First Aid default, too.

I think one could make a case that GURPS First Aid includes some of this. It's not just the modern basic training of "put a bandage on the red bit and call for help"; by TL6 it can take someone who's been beaten or stabbed to the point of unconsciousness and fairly reliably get them walking around normally.

(Modern first aid does include lots of other things, like anaphylaxis and cardiac arrest and heatstroke and whatnot, and obviously some people do more advanced versions of it if they're going a long way from help, but I'm thinking specifically of major trauma here.)