Merge Pharmacist and Physician

[Granodd]

The nuclear option is to just remove surgeon and pharmacist and make it just "Medical Doctor" who can do the roles of the other three with alt titles for Surgeon and Pharmacist. That way it would be delegated between Paramedics (treats people outside of medical to transport to medical) and Doctors (treats people inside of medical and more fully).

Which depending on how you look at it seems more fair given that the Paramedic is one of the least boring jobs given they're usually up in the current events versus Medical who get things second hand.

[Boggle08]

We have these threads every five weeks or so now. Nothing ever comes of them, we just debate in circles and then do it again another time. At this point, there's no way to make a proposition without severely compromising the play-styles of at least several people. We need to start trying shit. Playtesting, test merges. Even if it turns out to be a bad idea it puts us closer to finding the right idea.

 

4 hours ago, Peppermint said:

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

If half the bay can self supply, it wouldn't be unprecedented to have the fridge stocked roundstart with a small reserve of the tedious medicines that need to be made in bulk(mortaphentyl, saline, dermaline, etc) If medical bay is well staffed and functional, the physician isn't even supposed to be touching the OR. This makes them better suited to their home environment: The GTR.

Edited June 15, 2023 by Boggle08

[GeneralCamo]

I'm going to agree with this suggestion, with the caveat that Physicians get their surgery skills removed. This way we can cleanly delegate the medbay, and we can pare down that table that confuses pretty much everyone.

For those claiming chems are not necessary to save patients: You are correct. Just like it is also a correct statement that security does not need weapons to down mercenaries. However, I would still be loathe to send security after armed mercenaries with only their fists; the same should apply to the medical bay, in that I would be loathe to have them save a multiple casualty incident without chemicals.

Edited June 16, 2023 by GeneralCamo

[Sniblet]

I feel like no one's ever going to be happy as long as knowing your qualifications requires checking a spreadsheet in a different window, when it could be whatever makes sense for your character in this alleged RP game, or whatever is enabled by the tools you can access

• The engineer can set up any engine he wants. He can even set up thrusters. He can't do much cool stuff with them, because he can't get into the atmospherics lockers.
• The physician can do a few surgeries. She can only really touch the heart and lungs, because if she touches the kidneys, it's a problem, because the chart says that. The IC reason why the chart says that is because the chart says that (because the chart says that). She can't do much cool stuff with chemicals, because she can't get into the pharmacy lab.

There is one (1) difference between these two jobs in this analogy. I don't think physicians need pharmacy as much as something needs to be done about their relationship with surgery. If I were in charge, the first thing I'd try would be removing physicians, and the second would be letting research make drugs in the absence of a pharmacist. Notice how both of these make wiki charts redundant. I'm happy with things that have that effect.

Edited June 17, 2023 by Sniblet

[Melariara]

Some issues with this, listed below.

1.  Merging the two will encourage Super Physicians who do everything with no clear boundaries. We're going to end up with a mosh pit of people stamping all over each other to help assist a patient. Too many cooks in the kitchen will end with the death of a patient, as we see already sometimes with two responders and a responder intern.
2.  Merging the two will passively pressure Pharmacist players to learn more medical, and pressure Physicians to learn chem. Some people want to play medical without having to do first aid stuff, or physician stuff and just want to make funny chems because they enjoy funny bubble noise. Being a pharmacist or a psych means that you're last on the roster to do so, but you don't have to do it.
3. Merging the two will make Physician antagonist less manageable as they have more tools at their disposal. Self explanatory. They don't need this, especially with the (now)current PR open giving traitors more funny crystals to work with.
4. Merging the two puts more pressure on players in an already stressful department. Again, people shouldn't have to do what they don't want. Already we see CMO characters being forced to learn surgery, even if that isn't their background. Surprise, not all CMOs should/could be amazing at brain surgery! People in general shouldn't have to learn stuff that they don't want to.

In an ideal medical bay, the responders communicate that they're going out to collect someone. They stabilize the patient (bandage and salve bleeding and burns, inject with painkillers, inaprovaline), report back to medical what the injury is and transport back. The physicians then inject with fancy chemicals that the pharmacy has made to further stabilize/improve the general health and well-being of the patient in general, before they are being moved to surgery for fixing of broken bones/arterial bleeding/emergency surgery/whatever.

As it stands right now, pharmacists should be the last ones dealing with injuries, along with psychs. If there is nothing for your pharmacist to do, and you want to do more, watch the suit sensor suite. An extra pair of eyes is ALWAYS needed, ALWAYS helpful, to report on even the faintest blip. Pester the CMO for a refill of cartridges, demand operations use the money you've made from the single/double/x3 bounty to pay for it if there's no CMO. Restock the fridge. Experiment with fantastic mixes that'll never see the light of day because you know they might get nerfed into the ground. Just, be on standby for your medical.

 

TLDR? No. Please don't do this.

[Fluffy]

8 hours ago, Melariara said:

Merging the two will encourage Super Physicians who do everything with no clear boundaries.

In the simplest form of the proposal, they would do what they already does, with the addition that they can make the medicines, and assuming they do those at roundstart (which is when they have no patient, or rarely one) I do not really see they stomping all over each other, they're just preparing for what will come later in the round, in the same fashion as preparing the ORs/GTR/Cryotubes.

8 hours ago, Melariara said:

Merging the two will make Physician antagonist less manageable as they have more tools at their disposal.

Wouldn't they have the same amount of tools at their disposal as an antagonist Pharmacist? IIRC the Pharmacist can access the OR and potentially steal all the tools they want, an antagonist CMO would have the same tools too, and if it makes antags more of a threat? Good, we like powerful antags!

8 hours ago, Melariara said:

[...] Again, people shouldn't have to do what they don't want. [...] People in general shouldn't have to learn stuff that they don't want to.

This would be pretty arbitrary, can you be a Physician that only use cryotubes, or a Surgeon that only do fracture repairs, or a Pharmacist that only makes the 3 main chems, because you don't want to do/learn the rest? I don't think having to learn how to make the 3 medications that you really need to have to keep people from not immediately dying is a meaningful difference, you don't need to know how to make every medication.

[Sycmos]

Merging the two roles will just make people who enjoy Pharmacist but don't want to play Physician feel expected to learn Physician responsibilities, and vice versa. Engineering currently has a similar issue with players expecting Engineers to handle Atmospheric Technician duties when there are none. Nobody should be having their hand forced into mechanical play they aren't interested in.

[Shimmer]

2 hours ago, Sycmos said:

Merging the two roles will just make people who enjoy Pharmacist but don't want to play Physician feel expected to learn Physician responsibilities, and vice versa. Engineering currently has a similar issue with players expecting Engineers to handle Atmospheric Technician duties when there are none. Nobody should be having their hand forced into mechanical play they aren't interested in.

And yet, as engineering perfectly exemplifies it, when atmospheric technicians aren't on other roles can suffer and people's enjoyment of the game lessens.

I really don't get the argument of "People will have to learn!", it's such a non argument because you already have an ingame catalogue of all medicines and how to make them, it'd just be common sense as to what you as a physician need and use.

very few people play pharmacist, and as a result medical suffers, limiting chems to only pharmacists would be like limiting thrusters to only atmos techs.  

[Roostercat]

It very much is an argument and does not become invalid purely because you say so. People like playing pharmacist, and people like playing physician. Not everybody likes to do both. Just because engineering has an issue does not mean we suddenly need to cram medical roles together. They are completely different departments and different mechanics/gameplay loops altogether. That and being a pharmacist is much more complicated than just 'check the wiki' if you want a good selection of chems and that selection is not common sense. Not to mention the skill and muscle memory it takes to make a large amount of all of those in roughly half an hour, which is when people expect chems to be done.

[Shimmer]

2 hours ago, Roostercat said:

It very much is an argument and does not become invalid purely because you say so. People like playing pharmacist, and people like playing physician. Not everybody likes to do both. Just because engineering has an issue does not mean we suddenly need to cram medical roles together. They are completely different departments and different mechanics/gameplay loops altogether. That and being a pharmacist is much more complicated than just 'check the wiki' if you want a good selection of chems and that selection is not common sense. Not to mention the skill and muscle memory it takes to make a large amount of all of those in roughly half an hour, which is when people expect chems to be done.

That came across harsher than I meant, I apologise.

What I mean is that I don't really see the argument here, I think it's a better idea to just let physicians do chemistry and keep the roles as is, so that physicians can use the in game chemistry codex to make the chems they absolutely need (hence, common sense), and much like engineers leave atmos to atmos techs when they are on, so should physicians leave chems to pharmacists when they are on.

Mind, a similar dichotomy to what we have in engineering already exists in medical as is, Atmos techs are soft expected to know how to set up power for the ship, pharmacists are soft expected to treat people when no one else is available to do so, it's just that in medical it doesn't go both ways.

I still support a merge just on the grounds that it's a marginal improvement over what we have right now, but keeping roles, slots etc etc as is and just letting physicians do chemistry both keeps pharmacist as a role and allows medical to function properly without one.

Edited June 18, 2023 by Shimmer

[Fluffy]

27 minutes ago, Shimmer said:

pharmacists are soft expected to treat people when no one else is available to do so

They are, but if we go by the wiki, that should be treated the same way as a Physician making medications, currently, because the wiki page on them states:

Quote

"Pharmacists are fully capable of synthesizing mental medication, but they cannot diagnose mental trauma, or prescribe medicine."
"Pharmacists are unable to authorize medicinal treatments for patients. They are, however, able to issue chemicals (especially non-medical ones) per direct request, including medicinal chemicals with the approval of the CMO. They can check medical records for pre-existing prescriptions and provide them without the need for approval, however."
"They are not capable of acting as a Physician, as such they can only assist Interns and Trained Physicians in emergencies and not act in their place. However, they can be trained in basic first aid."

For how I interpret it, the wiki says that they should not be able to provide any help beyond what a normal person in any other department could, unless there's someone else like a CMO or Physician or Surgeon that scans the patient and goes like "Administer 10 of this, 5 of that, 5 of that other too [...]"

Of course, that absolutely sucks to play, being a Physician without a Pharmacist or CMO in a bloody round sucks, same as being a Pharmacist without the other roles, I do not think there's any value in "Let me/us watch you die / sorry I cannot do anything about your brain damage", neither from an RP nor from a mechanical perspective, and that also sucks to be on the receiving end of the "well I guess I will just have to go around with 30 brain activity slamming my head into the doors / well I guess I will just die / etc." for no other reason than "wiki says I cannot help you" too.

 

Something that can solve the points of "I do not want to do/learn X" is to keep everything as is, and add an alt title for the Physician whose meaning is "Yes, I can make medications", do not want to do the meds? Keep the normal title, do not want to do the GTR/Physician work? Pick the Pharmacist, cool with / want to do both? Pick the Physician with the alt title that lets you make the meds. Also alleviate the lowpop issue. Couple it with a stipulation that if there's an actual Pharmacist you should let them handle all the medicine production, and it seems to me it would be an improvement over the current situation.

[CatsinHD]

7 hours ago, Fluffy said:

Pick the Physician with the alt title that lets you make the meds.

I would support adding a somewhat non-invasive solution like this, but I would like to seriously consider if this alt-title would bring additional baggage. My only issue would be if there are no restrictions applied on what meds can be made, and whether the alt-title would be be allowed to perform surgeries. If both of those are true, then I would be less interested in this change simply out of the super-doc issue. Granted, adding even more tables is already a downside if we were to start restricting this and that.

If they were allowed to keep the normal physician surgical abilities, restrict the meds they can make to Butazoline, Dermaline, Dexalin Plus, Mortaphenyl, and Alkysine (including their lesser forms such as bicar). This covers brute, burn, oxygen, pain, and brain damage. You can run medbay with just these medications, and the ability to patch arterial bleeding and broken bones means Physicians can cover a dead shift. High pop obviously has the expectation that you stay in your lane and only cover whatever is lacking personnel.

[Sycmos]

18 hours ago, Shimmer said:

And yet, as engineering perfectly exemplifies it, when atmospheric technicians aren't on other roles can suffer and people's enjoyment of the game lessens.

I really don't get the argument of "People will have to learn!", it's such a non argument because you already have an ingame catalogue of all medicines and how to make them, it'd just be common sense as to what you as a physician need and use.

very few people play pharmacist, and as a result medical suffers, limiting chems to only pharmacists would be like limiting thrusters to only atmos techs.  

It is a fundamental issue with the mechanics of our server if we are wholly dependent on very specific roles to be present in the average round for players to enjoy it. The enjoyment of a round should not solely rest on a handful of players, because they in turn pay by sacrificing roleplay to make it available for others. That is neither fair nor suitable for a "heavy roleplay" server.

[Fluffy]

4 hours ago, William Murdoch said:

*snip*

I have pondered on this for a bit, and I do not think I can supply / find the optimal solution that covers everything, anything I can think of will make a portion of the players unhappy, including doing nothing

What I can offer are possible approaches and challenges to the points that are brought, eg. the idea of the "super-doc", I have thought about it for a while but I have not reached a clear conclusion about what that would be, what makes a character a "super-doctor"? For how I conceptualize it, it's a doctor that does more than what the other doctors can do, but that would be a self-defeating terminology because, if it will be decided that those doctors can make medications, they would not be doing anything more than their peers, thus they would not be super-doctors, right?

If it is conceptualized in the sense of impact to the round, aka mechanical role fulfillment, I am not sure it would be covered either: Are they more "powerful", in a round dynamic sense? I do not think so, their ability to cure people is the same as it would be if a Pharmacist or CMO made the medications 30 minutes before and cryoed, they are not able to "heal more" than what they would do normally. This also raises the question if the CMO is a super-doctor, because a CMO can make all the medications, physician work, and all the Surgeries. It also raises the question if Surgeons are super-doctors, because they can use all the medications and do all the surgeries. Perhaps I misunderstood the sense of the term and I am using the wrong frame of thinking about it, but I think it would be important to answer the question of what makes a doctor be considered a super-doctor (?)

 

My initial proposal/idea was to split what each role can do, and it would have had some expected benefits like the ability to mantain a more or less even distribution of patients between the roles during mass causalities moments, and alleviate the issue at low pop, it however also has disadvantages such as distilling it more into a flowchart of separations between the roles more, as Limette validly pointed out.

 

Another option that I thought was to make some medications expire after N amount of time, so that the Pharmacist would be needed to make them on-demand instead of stocking the fridge and being mostly with anything to do for the rest of the shift; Another option would be to give the Pharmacist an alt title as a first responder, given the time difference between when the two mechanical aspects are performed (making meds is generally covered by 00-40m, grabbing patients is generally covered from 40m to round end); Another option I thought of is to just add an automatic medicine maker that makes medications, on demand, overtime for the Physician, with the time taken proportionate to the complexity of the medication requested.

 

There are many possible approaches that can be taken, but I have so far been unable to think of a solution that has only benefits and no downsides, we might just have to accept some lossess somewhere, whether it be variety, accessibility, time to learn, expectations and so on.

[Omicega]

The surgeon/physician merge should have passed its poll and it's criminal that it didn't. I think that was a much smoother solution than proposing the same thing for pharmacists and physicians, personally. There's no large burden of knowledge added to the physician job like Rooster points out -- you wouldn't have to learn a million trillion efficient chem recipes, you'd just need to learn minor variations on the surgeries that physicians already know. Merging the two jobs into one four-slot role would help solve the job bloat and, with surgeon being added as a physician alt title, still allow people to express a preference for taking priority when it comes to surgical cases.

[Boggle08]

18 hours ago, Omicega said:

[snip]

Hey, I'll take that. Fixes half the problem, doesn't have the logistical complications, and it actually got to polling.

I feel like any kind of vote or polling about medical's features in the future needs like, a 60% majority or more from the no camp in order to slap it down, because look how productive these threads are.