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Merge Pharmacist and Physician


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I am proposing we merge the pharmacist and physician roles into a general chemist/GTR role named Medical Technician with an alt-title of Nurse (plus other suggestions). Why?

Physician is the GTR role. First Responders can do almost everything a physician does, but they get to leave the department. Surgeons get to do everything a physician does, but do all surgeries. Pharmacists, when asked as I have been increasingly so in the last few weeks I've played, can do everything a physician does, but they get to make all of the chems. This is not a long affair, and my best times for completing all of the chems is currently hovering around 11 minutes using an old guide made by Vrow on my second monitor and a cryo mix guide from Ramke (with some practice). The issue is, Pharmacist does not have a real gameplay loop outside of making these chems, which are essential to the success of the medical department, without being asked to assist in the GTR. Physician also doesn't have a gameplay loop outside of being in the GTR treating patients, which all of the other roles can already do and then some. By merging the two, we reduce these gameplay loop issues, since the medical technician can make chems at the start of the round and remain on standby for people coming into the GTR for the remainder of the round. 

The primary issue with this that I can see is going to be existing roleplay for medical doctors. Going from Physician to a general "technician" role would be almost a retcon and deprive characters of the doctor title. Leaving it as physician would be fine, but traditional job separation on SS13 might make it so that physician players may not think making chems is part of their role. Tell me what you think.

 

EDIT: I'd also support having 3 medical techs instead of 2 pharm/2 physician, just so it doesn't feel like medical loses manpower in dire emergencies.

Edited by BLUNTFORCE420
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I do not think it would even need retcons or anything like that, honestly... Just nuke the Pharmacist slot, say that the Physician can make medications, change the access of the door to let them in, and that's pretty much the minimum viable product

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I think a renaming is unnecessary, especially to something meaningless like medical technician, which sounds too close to an emergency medical technician which is a different thing all together.

Keep physician as the name, give them access and allow them to make chems, maybe increase their slots, pharmacist as it stands is played by too few players and is extremely debilitating when they're not on.

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53 minutes ago, BLUNTFORCE420 said:

Surgeons get to do everything a physician does, but do all surgeries. Pharmacists, when asked as I have been increasingly so in the last few weeks I've played, can do everything a physician does, but they get to make all of the chems.

I'm honestly more inclined to just remove physicians. You've kind of pointed out they're a superfluous feature in this line right here.

That isn't what this thread is about though, and if this merge happened, I'd prefer physician just get an extra slot and an alt-title so you could pick what you wanted to do.

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I don't mind pharmacist being merged into physician, but I would like physicians to specialise in either surgery or pharmacy as their secondary spec (currently a physician can only do some surgery). Alt title or just pharmacist role rename?

The reason why I think this way is I want to avoid super doctors like CMOs. If you spec in surgery, you can't do chems and vice versa.

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Medical is the most needlessly delegated department out of all of the departments. 

Engineering is delegated between Engineers and Atmos Techs (2 Jobs).
Security is delegated between Officers and Investigators (2 Jobs).
Cargo Operations is delegated between Miners and Cargo Techs (2 Jobs).

Science I won't really count given that it's one of those departments that's nonessential (like Service). And Service is fairly spread in delegation too but unlike Medical, the field of Service is not a high-skill job, and so it's not hard for people to swap around inside of that department (if they wanted to, not that they should...)

Medical, however, splits up the duties of its department - one that is not only a high-skilled RP wise, but essentially needed in any round where the crew have a pulse. The absence of any of the medical jobs requires the rest of medical to drastically adapt to fill in that void. Or just cope if certain jobs are missing (e.g. If the Pharmacist is missing have fun saving people with limited supplies of Dex+ and no Alkysine). Surgeon also presents this issue but to a lesser extent seeing as a combination of Physicians and Pharmacists can sustain people pretty alright.

Just merge Pharmacist into the Physician's skillset so that Medical doesn't have to cope when there's no advanced chemicals in their medicine fridge and suddenly they need more than just one bottle of Dex+.

And no the argument of "just get good at treating patients without Dex+ and Alkysine" is not a valid argument when your patient count is anywhere over two.

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44 minutes ago, Granodd said:

he absence of any of the medical jobs requires the rest of medical to drastically adapt to fill in that void.

I can agree that the roles can be merged if they really must, but I decisively disagree with this statement. You never need chems to save anymore. You dont need a pharmacist. You only need a competent surgeon. The rest of your tools is available in such abundance even without the pharmacy lab's lights on, I still dont get why people insist on saying you need a pharmacist. Its just not true. 

a) You dont need chems at all, when you have a surgeon.
b) Even if you need chems there are a billion useful chems spread around the ship, wall lockers, medkits, etc.

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Physician and pharmacist are too different of roles to merge, in my opinion. If the only part of gameplay I want to access is the chemistry side of things, I can do that as a pharmacist, and never have to touch the GTR. By merging pharmacist and physician, sure, this role now has more work cut out for it, but now there is no single role that can access any chemistry side of gameplay, besides making a scientist who specialises in exploratory chemistry, but there's virtually no direction to be had in the exploratory chem lab. I don't want to have to play physician (or medical technician, as proposed) - and all the GTR work which comes with that - just to play the little part of Medical I like, pharmacy, which now I'd have to fight over for with all the other physicians on the manifest. I'd rather see surgeon and physician merged, if the problem is physician having to little to do.

Granodd mentions security as only being delegated 2 ways, however they forgot warden, which is similar to pharmacist in some regards, in that they are a gatekeeper to advanced security tools, less-involved in the 'intense' aspect of a department, have direct-entry to BrigRP, and are sometimes seen as the more roleplay-focused role compared to officer. If, for whatever reason, warden and officer were merged, there is no longer a direct-entry role to the chill side of BrigRP, and you're stuck having to handle everything that an officer has to handle. Some people probably wouldn't like that, and it's largely the same case as pharmacist and physician as the roles have a lot in common.

Drawing attention to Ping's point, never has there been so many chemicals not only interspersed throughout Medical, but also Engineering and Operations now. Chemicals just sitting around, you can go on to include all the chemicals that have, this past year, been added to the ordering terminals, such as peridaxon, but also warehouse spawns. The idea that Medical is totally gelded without a pharmacist doesn't really hold that much weight. It makes things trickier, but that can be said for any department that is lacking a role. Maybe a hot take, but I've sometimes preferred pharmacist-less medical, as it raises the stakes for command and security, as they no longer have free tickets out of any and every injury they receive at the hands of an antagonist - death is an important part of antagonists escalating and contributes to more interesting rounds.

Edited by kermit
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You don't need a pharmacist any more. Hell, you only really need a surgron when someone has brain damage (which cryo tubes fix, though it takes a while) If people are willingly joining as pharm/pyhs, I feel they know what it is they're signing up for. Medical is now so incredibly wellstocked that outside of mass casulaities, there's not really any excuse for struggle to save people without an entire department as it used to be. The sheer amount of chems and buffed up kits has seen to that.

A few other things:

- I  do not feel we've gained any roleplay value from the removal of alt-roles. They added flavour and we should have just enforced doing basic stuff harder.
- This just makes a super doctor. Physicians can already do most surgeries. Add chemistry on top and it gets a little silly. It's the CMO issue all over again. If we then remove surgery from physicians, it's the exact same but now with the more boring work to do.
- Regardless of what's done, the main issue seems to be the chemist role minigame is just boring. This doesn't fix that. It just gives it to someone else.
- We already polled a similar thing and it was voted against. It's the same logic but in reverse.
- Medical just does not need to be made easier. It's not that difficult any more. And stripping even more away from it just ensures that.

The only way I can see this working is making pharm/phys an alt-named job, and even then that kind of just increases the issue. I've never understood the arguments that you can't do much on physician, as it's very clear what the limits of that role are when you decide to hit the join button, with the upside being you get less mechanics in favour of more roleplay. It's been a hot sec since the surgeon super doctor era and I've not really noticed it being a thing any more.

Yes, dying sometimes sucks. No power sucks. A lowpop vamp round with no security sucks. But balancing around lowpop times is such a massive waste of time which is the only time it feels this is ever relevant. 

Edited by Peppermint
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Medical is comically sub-delegated. It does not need four roles, and anyone who plays medical can attest how ridiculously bloated the department feels when the manifest is full. Physicians are already in the weird venn-diagram overlap between first responder and surgeon, and nuking the role would make surgeons and FRs feel like complete jobs with more to do. If merging pharmacist and physician reduces the total slots and roles, then amen, though I think simply nuking physician or merging it into surgeon would be better. 

On a different note, first responder is very popular, and by killing physician in one way or another you could probably have three FR slots to reflect their increased role in stabilizing in triage. 

Some people above are talking about how med doesn't need to be easier- if anything, killing/merging two slots should add a little strain back to the department. 

Edited by Nol4
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I can't say I precisely like the idea of this, as unlike the suggestion to merge Surgeon and Phys, there's a lot less overlap here as you can fairly comfortably play a Pharmacist that doesn't do Physician work - whereas a Surgeon is often obligated to do the work of the Physician. It's a fairly low-stress role, a rarity in it's department, and I'd hate to see that gone by merging it with Physician. Alt-titles wouldn't really solve this either as you'd get the Roboticist 'issue' of people being OOCly upset at you that you can't/won't super-doctor because you picked a particular specialist alt-title, an issue Engineers had prior with their now-removed specialist alt-titles as well.

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5 minutes ago, Nol4 said:

Medical is comically sub-delegated. It does not need four roles, and anyone who plays medical can attest how ridiculously bloated the department feels when the manifest is full. Physicians are already in the weird venn-diagram overlap between first responder and surgeon, and nuking the role would make surgeons and FRs feel like complete jobs with more to do. If merging pharmacist and physician reduces the total slots and roles, then amen, though I think simply nuking physician or merging it into surgeon would be better. 

On a different note, first responder is very popular, and by killing physician in one way or another you could probably have three FR slots to reflect their increased role in stabilizing in triage. 

Some people above are talking about how med doesn't need to be easier- if anything, killing/merging two slots should add a little strain back to the department. 

FR already feels like a complete job. So does surgeon. If anything this change would make FR feel worse because you now have a role that can do surgery + chems + already go out and do everything an FR can. Making three FRs is just plain silly and would lead to even more fighting over patients. 

I also disagree the department feels bloated with a full manifest. Everyone has a specific role and can do said role without stepping on each other - it's the quieter rounds this would impact more.

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To echo and respond to some thoughts here with my own:

- I agree with Ping wholeheartedly. Specialised meds are a banefit that helps a physician, but not a requirement. All stabilisers aside from Dex+ (which is not mandatory, there are workarounds that work just as well already available in GTR, i.e. stasis bags/beds, dexalin, adrenaline, lung jabs and pneumalin) are already in pill/inhaler form and in abundance - most people also just dilute the pills for easier hypo injections. This is not including the RNG aspect of Ops sending you combat medkits with dex+ and all the other goodies as well.

- Some people find pharmacy work boring and they would not want to deal with this obligation. I personally love it and hate surgery, but the inherent issue with pharmacists is that after you put everything into the fridge (which takes ~10-15min for a pharm main), you are now a potted plant for the rest of the round unless it's so chaotic you HAVE to step in.

The reason I would support merging physician and pharm, but keeping it separate from the current Physician (alt title, rename pharmacist, something like that) is that it will allow those who enjoy the chem minigame to continue enjoying it, but it opens the door to have gameplay for the rest of the round as well. It would also avoid the super doctor meme, and any OOC upset that it may cause. I feel like this would hopefully address Peppermint's points.

I personally disagree that there should be more physician slots or FR slots. We have enough. Having played Physician for a few weeks recently, highpop with two physicians, two surgeons, two responders, CMO and so on is already enough in most cases. Two pharmacists is already too much imo.

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2 hours ago, Nol4 said:

Medical is comically sub-delegated. It does not need four roles, and anyone who plays medical can attest how ridiculously bloated the department feels when the manifest is full. Physicians are already in the weird venn-diagram overlap between first responder and surgeon, and nuking the role would make surgeons and FRs feel like complete jobs with more to do. If merging pharmacist and physician reduces the total slots and roles, then amen, though I think simply nuking physician or merging it into surgeon would be better. 

On a different note, first responder is very popular, and by killing physician in one way or another you could probably have three FR slots to reflect their increased role in stabilizing in triage. 

Some people above are talking about how med doesn't need to be easier- if anything, killing/merging two slots should add a little strain back to the department. 

As someone that plays medical, it really doesn't feel bloated. In fact I think the four roles we have works perfectly fine. I really don't understand why people keep coming in to try and merge all the roles together so it just winds up as eight or more people doing the same exact thing. THAT would make the department feel bloated.

 

Beyond that, I echo Sophie's reasoning. Not a single time have I ever felt the removal of roles benefitted the roleplay environment even slightly (except some of the engineering ones and the two dif phys titles, the electricians that refused to set the engine boiled my blood). All it does is blob everything together and make it all samey and boring. Big -1

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2 hours ago, Peppermint said:

FR already feels like a complete job. So does surgeon. If anything this change would make FR feel worse because you now have a role that can do surgery + chems + already go out and do everything an FR can. Making three FRs is just plain silly and would lead to even more fighting over patients. 

I also disagree the department feels bloated with a full manifest. Everyone has a specific role and can do said role without stepping on each other - it's the quieter rounds this would impact more.

They both feel like complete jobs right until a physician shows up, then they both feel like half jobs to me. IMO surgeon and FR gameplay are at their best without any physicians, when they're working together to stabilize patients in GTR and transport to surgery. I agree that merging pharmacist and physician is sillier than merging surgeon and doctor. 

I play chiefly FR, and a full medical manifest is a deterrent to joining a round. There's just not very much to do even during a total bloodbath with four doctors + a grab-bag of interns + a pharmacist or two treating people in GTR + a CMO running around + another first responder. 

I'm certainly not attached to more FR slots, and wouldn't want it at all unless physician was removed entirely. 

Similarly!

8 minutes ago, Roostercat said:

As someone that plays medical, it really doesn't feel bloated. In fact I think the four roles we have works perfectly fine. I really don't understand why people keep coming in to try and merge all the roles together so it just winds up as eight or more people doing the same exact thing. THAT would make the department feel bloated.

Merging without reducing total slots would be a disaster, fully agree. 

The two problems as I see them:
1. jobs step on each other constantly because there really isn't three full jobs worth of content. Just transporting or just operating is not a fun gameplay loop.
2. there's so many warm bodies in medical 

Merging/killing physician solves both nicely. Obviously people have reservations- I think you have to play the alternative to feel it. I come from Bay which has two doctor-surgeons and three first responders (and a pharmacist). The smaller medbay means everyone stays busy and collaborates, and the flow just feels much nicer than Aurora's weird three overlapping role-boxes. 

Edited by Nol4
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Possible other approach:

 

Pharmacist → Removed
Physician → Two alt titles, I will call them with the two first names I can think of, they can of course be changed: "Internist Physician" and "Pathologist Physician"

 

Internist Physician → As the name implies, it's an internist type of doctor (internist aka hospital, not related with interns ie trainer role), is specialized in medical work inside an hospital
Pathologist Physician → A doctor specialized in treating pathologies

 

Intern Physician can:

  • Perform the following surgeries: Bone Repair, Arterial Bleeding repair, Tendon Repair, Foreign Body Removal, Lung Repair
  • Make the following medications: Inaprovaline, Dylovene, Butazoline, Dermaline, Dexalin Plus, Mortaphentyl, Adrenaline, Alkysine, Adipemcina

Pathologist Physician can:

  • Perform the following surgeries: Bone Repair, Tendon Repair, Foreign Body Removal
  • Make the following medications: All of them

Surgeons can:

  • Perform the following surgeries: All
  • Make the following medications: Inaprovaline, Dylovene, Butazoline, Dermaline, Dexalin Plus, Mortaphentyl

 

Stipulations:

  • If at least one is available, medications production must be left to the Pathologist Physician
  • If at least one is available, surgeries must be left to the Surgeon
  • If at least one is available, patient acquisition should be left to the First Responder
  • If at least one is available, the GTR should be left to Intern and/or Pathologist Physician(s)
  • Both the Intern Physician and the Pathologist Physician can operate in the GTR, but with different methods: The Intern Physician treats basic things with medications and more complex things through surgery if there's no Surgeon, the Pathologist Physician treats most of everything via medications
  • The Pathologist Physician is expected to fill the First Responder role if none is available, at which point when you'll be needed to do such 40+ minutes have passed and you probably already made all the medications you can think of and some more
  • Do not want to do medications? Select Intern Physician, you can make the basics you need, can't make the more advanced medications (so no OOC upsetness), and can do surgeries to some level
  • Really like that scalpel? Select Surgeon, you can make the bare minimum amount of medications you need for the patient to not immediately die in your hands, and get to treat everything else via the scalpel

 

Expected benefits:

  • Medbay can function and scale at high and low pop, one role filled (FRs apart) is able to treat most of everything, so that noone gets the short straw
  • There's no superdoctors, if you can make the meds, you cannot fix the same type of issue surgically; If you can fix it surgically, you cannot make the meds for it
  • You keep having things to do: If you are a Pathologist Physician, once your medication production cycle is over, you can still play in the GTR/ICU to treat the patients; if you are an Intern Physician, you keep having things to do via the GTR itself and surgeries; If there's no FR on shift, the Pathologist Physician gets to do the recovery of the patients while the Intern Physician gets to manage the GTR, if there's a Surgeon, the Surgeon gets to manage the OR
  • Any two of the three roles can be missing, without making the one that is filled excessively suck
  • You still get things to do, more or less spread consistently across the round, in any combination of roles, it doesn't suck as much to be alone, and you aren't left spinning your thumbs at full roster

 

Thoughts?

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I'll throw my hat into the ring.

So far I have played every role in medical extensively with the sole exception of pharmacist and intern. I have dabbled into pharm, but it just isn't the gameplay for me. It's not that it gets boring after 10 minutes, I just don't particularly enjoy sitting at the chem dispenser. Regardless, I'll continue.

I do not like the idea of merging any roles in medical.  I don't agree that First Responders have enough to do. In all my time of playing FR, I've either been bored as hell RPing in the bar, or running every which way along the ship trying to help security, random injuries, miners, etc. I have yet to find an issue where I had so much time that I could play mini-phys just without the doctorate. As for Surgeon, it goes either way. I am either stuck in the ORs with patient after patient, or I have none at all and simply watch the physicians do their work (yes, I am in the minority of people who don't treat patients in the GTR as surgeon unless they need the help). With that being said, situations change based on pop, round type, etc. Not every round will FR have a lot of work, same for surgeon, same for physician. They have their roles. If people can't respect the boundaries between the roles, that's a player issue. I have never had or seen a problem with each role's section of medical (except the excel spreadsheet that is the surgery table).

HOWEVER, I would be willing to see some change to the job roles if it was wanted by the majority of players and the maintainers. My idea is this: split physician in two and give it to pharm and surgeon. First Responders are excluded from this.

The two new roles from this are Surgical Physicians and Pharmaceutical Physicians (names subject to change). Both can work in the GTR. The Surgical Physician is capable of surgery, this is essentially merging phys and surgeon. The other, pharmaceutical phys, isn't capable a surgery but can produce any and all medicine such as peridaxon, adip, alky, etc. Two separate jobs, two separate access regions, two separate focuses. Pharmacists now have something more to do than chemicals, and surgeons can help in the GTR without fear of stepping on toes that they shouldn't be stepping on to begin with.

Why stop pharm phys from surgery? Simple, I absolutely fucking despise super-doctors. CMOs barely get a pass from me, and that's entirely because I can empathize with being forced to act as a super-doctor at times. Plus, this way the surgical table gets simpler. Only 3 people (really only 2): machinist, FR, surgical physician.

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1 hour ago, Fluffy said:

Thoughts?

in general i think this is the worst proposal in the thread, to be blunt. it would require expanding the Surgery Table to be even more daunting to approach, it would require something like a Chemistry Table, and it would leave more issues in regards to if you have both phys as one alt-title. i don't recall any of these things being liked by the community. the entire idea feels like it would distill medical even further into being a strict flowchart than it is already - which right now is FR -> Phys -> Surgeon with Pharm being parallel - annoying, but simple enough compared to adding a pharm flowchart alongside it.

not to mention that 'internist' would be confusing versus 'medical intern' in particular for people who dont actually work at hospitals.

Edited by limette
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33 minutes ago, limette said:

it would require expanding the Surgery Table to be even more daunting to approach

Does it, though? Because the summary of it is a simple "Don't treat surgically things you can make meds for", thus basically completely eliminating the chart (or at least, being very easy to remember):

"Can I make a med for it? If no, I can do the surgery, if yes, I cannot do the surgery and must make the med"

That's pretty much all there is to remember there, alongside a small chart (which is now smaller than the surgery one, containing only a couple of names) of what medications you can make.

 

40 minutes ago, limette said:

it would leave more issues in regards to if you have both phys as one alt-title

What kind of issues are you thinking of?

 

41 minutes ago, limette said:

not to mention that 'internist' would be confusing versus 'medical intern' in particular for people who dont actually work at hospitals.

Yes, the names I came up with are provisionally, they can be changed to whatever names are wanted without any issue.

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Cool idea but I will disagree in the end because right now you can already fully heal somebody without chems in the current code.

 

Yes, it's a pain in the ass, but, you're not meant to be 100% efficient at all times. If pharmacist got merged with physician, medbay's efficacy would increase too much and I believe it would affect game balance, especially on rounds with a lot of combat.

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People will say "Oh you don't need a pharmacist at all when you have a surgeon" when there's only two surgery tables, and any given surgery takes between 1 - 5 minutes depending on how skilled the player is.

And in that time, your patient is still actively dying. If their blood oxygen levels are dropping and you don't have dexalin while they're on the table, you're going to have a bad time. If the blood oxygen is the only issue, then prioritizing the lungs may work. But if there's multiple things wrong with the patient, then you're going to have a much harder time.

And that's assuming you only have two patients. And like I said before.

11 hours ago, Granodd said:

And no the argument of "just get good at treating patients without Dex+ and Alkysine" is not a valid argument when your patient count is anywhere over two.

The purpose of chemicals is that it works while you work. You inject medicine so that it keeps certain ailments from getting worse in the time it takes you to solve another. This is especially true with more than two patients, because it helps keep critical patients stable before more proper care can be rendered.

Not having a pharmacist but having surgeons may not be the end of the world, but it puts far more strain onto the existing medical staff than if there is a stocked medical fridge. Which is why it would be better to just combine pharmacist into physician so that they can create the things that make their lives easier.

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A pharmacist that finishes their 30 minutes of work + surplus can just cryo, wait, and respawn as something that is supposed to be using their chems.

A physician without chems is just a shittier surgeon. The wall lockers we added several months ago are a bandaid for a role that can't do much except scan people and pass them into the OR if they can't medicate. 

Current medical is a big, sloppy, inefficient compromise. It proliferates its existence because everyone is just comfortable with it. I think we feel good about it right now because medical is consistently staffed, but the next time we get hit with a pharmacist populations drought, we're gonna be right back in another thread asking for more chems to be put in the walls.

 

In my view, the best way to merge and streamline these roles properly, is to knock out the pharmacist as a dedicated linecook role, and essentially turn the physician into a pharmacist with GTR responsibilities. With NO SURGERY. The surgeon becomes our dedicated meat technician. No charts. No bullshit. Clear division between responsibilities without redundant intermediaries. With this division, it makes a stronger case for the maintainers to allow alt titles again. No chart bullshit, no finagling over responsibilities, you either pick scalpel, or hypo.

Having played a shit ton of solo pharm in the past. It's doable. More than doable. Outside of a handful of important fixes, there are many, many workarounds to problems using chems. And when there is a problem you can't fix yourself, or if it's quicker to do surgery, having one is all the more valuable and appreciated. It doesn't feel arbitrary.

Pharmacy work is boring, and there is usually only ever one pharmacist at a time, because late joining as a second usually makes you honorary off-duty. With a more populated, merged role, you get more people to consistently staff both sides of the chem lab, and that leads to divvying up the tedium into something more manageable, and fast. Since physicians will now be able to self supply, they don't even need to make bulk orders like what the pharmacy has to put up with. On lowpop, they can use a mix of wallmeds and a few bottles here and there wherever they see fit.

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I should also add, it makes it more straightforward to design features/challenges between the two roles. Rather than having to think about medical as a quasi-political balance of power, it becomes a binary between chemical/GTR problems, and Surgery/OR problems. It will make it easy to conceive of design for the department going forward.

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Giving phys chemistry and taking away surgery just gives them an even shitter deal. Being expected to make chems which is incredibly boring. Medical right now isn't perfect, but I don't think we're gettig much better without a big chem/science rework which just ain't happening

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