Open Question: What could we add to make physician a more unique role?

[Sheeplets]

Not a suggestion thread of my own, I just wanted a place to gather other people's ideas.

Physicians, to me, have always sat in an awkward spot where like they lack the same distinction as the other Medical jobs. It's extremely easy to step on their toes, to the point where their gameplay loop even existing almost comes at the mercy of an unwritten social contract between them and paramedics to not do too good of a job patching people up outside of the Medical Bay just in order for them to have something left to do when a patient rolls in. They often have a tendency to fight each other for crumbs just because of how much they overlap. Everyone else gets a unique "thing" that only they can do which makes them stand out, and by extension become irreplaceable. Physicians don't, and you probably wouldn't even notice that they were gone if you had pretty much anyone else to do their work due to it being so generalized. Meanwhile, without a pharmacist or a surgeon the team's capabilities would be crippled because their roles are impossible to fill without very clear and deliberate powergaming. It gives these other jobs a nice degree of separation that I think could also apply to physician, because I know it's frustrating to play one and have your job done for you. I think we should give them more things that mechanically only they're capable of doing, I'm just not sure what. To be clear, I wouldn't want them to be put in spot where the rest of the department would suffer without them. It'd just be nice if they had more stuff that only they can do, so nobody has to worry about accidentally taking away their work.

TL;DR - Physicians don't have their own "thing" that only they can do and they're easily, and often overshadowed by usually well-meaning players in the department. If we gave them more specialized work to do I believe it'd help give them a better defined lane to occupy and a clearer identity. I'd really like help with ideas for things that could reasonably be added or changed to do it.

Edited July 25 by Sheeplets
Edited to (hopefully) make more sense, I'm sorry if the OP was confusing.

[wowzewow]

39 minutes ago, Sheeplets said:

Meanwhile, if you tried to run an intense round without a pharmacist or a surgeon it would absolutely cripple the team's capabilities.

I think an easy solution would be to allow Physicians to do some very rudimentary chemistry. And physicians can already do basic surgery. I found it strange that CMOs can do advanced chemistry that while normal physicians can't do basic chemistry.

Also, physicians can basically hold down the entire fort solo on lowpop.

I think the problem stems from people believing that everyone in medical *has* to have an absolute prime directive - a side effect on how absolutely laser focused on mechanics the whole department is most of the time.

Thing is, it doesn't have to be a bad thing, or a "problem" that needs to be solved, Physicians can do some RP by doing checkups, surgery, EMT-ing, trauma, sensor-watching...

The only real time this issue compounds is on highpop, honestly, when every role is *absolutely* filled. But at that point I'd just say to "find your own fun" like any other less-mechanically intensive job on Aurora that has to do EVERY ROUND, mind you. (Psychologists crying in the corner.)

Physicians are a jack of all trades, master of none. Unfortunately people are way too focused on the "master of none" part.

At the end of the day, that's their role. A relatively safe pick in majority of situations if you just want to *play medical* without thinking too much.

Edited July 24 by wowzewow

[MattAtlas]

5 minutes ago, wowzewow said:

I found it strange that CMOs can do advanced chemistry that while normal physicians can't do basic chemistry.

it depends on the CMO's background. non-chemist CMOs cannot do chemistry

[CatsinHD]

TLDR; It's a difference of approach imo. They're the middleman meant to manage the GTR and make the medbay run smoothly. As Wezzy said, jack of all trades.

2 minutes ago, wowzewow said:

I found it strange that CMOs can do advanced chemistry that while normal physicians can't do basic chemistry.

This is actually false. CMOs, by default can NOT do advanced chemistry. In fact, it is questionable if CMOs can do basic chemistry. The exceptions to this are CMOs who come from a pharmacist background. It is the same deal for a CMO coming from a physician background doing neurosurgery. That isn't allowed and is ahelpable.

 

As for the OP, I think some of the issues are really just a different approach to the role. Outside of Paramedics participating in borderline powergaming, which need to be ahelped b/c that shit isn't fun for everyone else, Physician is the middleman. Their entire focus is managing the GTR, and managing patients. In fact, on high-intensity rounds when we have a lot of patients I ADORE physicians as a paramedic because they can manage patients who are post-surgery, waiting for surgery, and just came in and need to be "processed' (yes I know my language is very industrial and clinical).

As Wezzy mentioned, when things are not batshit insane, it's kinda on the player to find RP opportunities. It's the same for every other position in medical, in the end. In these times, though, the lanes that medical has that cause oh so many debates really shine. Surgeons are surgeons, they don't belong in the GTR. Paramedics don't have M.D.s, they need to stay away. That patient is YOURS until you hand them off to either go home, get surgery, or whatever else. Take advantage of that, and make sure everyone else respects the lanes.

Before I end off my ramble, I want to circle back to the paramedic issue, because I am a Paramedic main and it boils my blood sometimes.

55 minutes ago, Sheeplets said:

unwritten social contract between them and their paramedics to not do too good of a job patching people up outside

This is sorta an on-going discussion, it feels like, but seriously. If a Paramedic brings a patient back who has already been given buta, derm, and/or pneumalin and fixed basically the entire issue, ahelp it. It is ruining the fun for physicians when the entire job of the Paramedic is just to stabilize and return patients, NOT to treat them. The exceptions are emergencies, like away-missions and the like. Paramedics are not doctors, they should never be as effective as one.

[Sheeplets]

Please don't let this derail.

Maybe I framed my initial post poorly, I was hoping to hear suggestions on what we could add to specifically give the physicians more to do, that way people don't have to worry about overlapping lanes in the first place. Something that, in hindsight, might take more work than I anticipated.

Regardless, I think it's still worth spitballing since other people may have some good ideas that they'd otherwise keep to themselves and could very well be worth pursuing.

[Fluffy]

If there was a way to do that, we'd probably have seen it already, since the topic of Medbay roles comes up every couple of months without exception, just with different words from the previous 27 ones

I don't see a way that wouldn't either axe some roles, or require a chart for what they can or cannot do

 

Surgeons can do everything Physicians can do, and more ontop of it; Paramedics can do most of what Physicians can do

Without something that outlines what each role can exactly do (and not in an ambiguous way like Cats describes), I don't see anything changing, and since it seems people would rather have the black plague than a medications chart or have to learn other things to have some roles combines, we're stuck at this point until some playerbase side caves in, or the staff decides to pull out the hammer and implement the change like it or not (for the better or worse)

 

If you ask me, I reiterate one of the versions of what I already said in at least 3 other topics, TLDR:

- Axe Pharmacist
- Physicians can make most of the medications, science can make the most advanced ones (""exploratory"" chemistry might aswell not exist at the time, otherwise)
- Surgeons can only make the basic meds, and all the surgeries
- Paramedics can only use the basic medications the Surgeons can make

Other options are possible

[Roostercat]

Everyone, keep in mind that what sheeplets is looking for is "It'd just be nice if they had more stuff that only they can do, so nobody has to worry about accidentally taking away their work." 

This is not a thread discussing whether or not physicians/surgeons should be replacing pharmacist. Sheeplets is trying to brainstorm new things that ONLY physician can do to make them more unique.

One idea I have is the addition of new slightly mechanical/fluff disease processes through character creation that the physician can interact with. Think diabetes and pulmonary fibrosis, things like that. They aren't terribly likely to send characters to med hell (okay pulm fibrosis might) but they provide a nice reason to go into medical to see the physician. 

[hazelmouse]

12 minutes ago, Roostercat said:

Everyone, keep in mind that what sheeplets is looking for is "It'd just be nice if they had more stuff that only they can do, so nobody has to worry about accidentally taking away their work." 

This is not a thread discussing whether or not physicians/surgeons should be replacing pharmacist. Sheeplets is trying to brainstorm new things that ONLY physician can do to make them more unique.

One idea I have is the addition of new slightly mechanical/fluff disease processes through character creation that the physician can interact with. Think diabetes and pulmonary fibrosis, things like that. They aren't terribly likely to send characters to med hell (okay pulm fibrosis might) but they provide a nice reason to go into medical to see the physician. 

I'd absolutely love more fluff diseases. Right now, the breadth of ailments you can actually inflict on your characters that have any mechanical representation is extremely thin. If someone wanted to attempt to tackle more complex disabilities, like making asthma more mechanically complicated or introducing more illnesses like diabetes and pulmonary fibrosis, I'd absolutely love to see what they could come up with. Think pre-existing conditions that may proc off certain things, may require particular treatments, may require medical oversight during recovery, but aren't particularly lethal.

If they did that, another thing I do believe is that the recovery ward should be less remote. It's never used right now because of how far away it is from everything and everyone, if we ever want to push more low-intensity medical roleplay with some mechanical backing then it'd be best if recovery facilities were readily available and understood to be in the domain of physicians.

None of this gets added until someone actually puts the time in to code it, though.

Edited July 25 by hazelmouse

[Peppermint]

Return alt-titles and get rid of physician entirely, like we used to have, at least before the whataboutism from like 2 problem players caught on. For an RP server, Aurora is so terrified of actually allowing for meaningful character RP, but that's such a different problem I don't ever see fixed.

Otherwise what about allowing people to add fluff sicknesses or whatever to their character via the organ tab or something, then have these show up in a scan? I don't think these should really be mechanically backed up though, at least for now, simply because I don't know who would code it as that'd require quite a lot of work. People could come in with their fluff cold or whatever and not just have the intern tell you "Omg ur fine, the scan says so??" 

The return of virology could also happen I guess, but that one was kind of annoying to deal with. 

Edit:  Oh wait someone already suggested the same thing lol, my bad for not reading properly. Agree with that take, would be cool.

Edited July 25 by Peppermint

[Fluffy]

4 hours ago, Roostercat said:

Sheeplets is trying to brainstorm new things that ONLY physician can do to make them more unique.

There isn't one, that's the point: Anything a Physician can do, a Surgeon can do, since the Surgeon is just a Physician with additional training ontop of it

Physicians deal in medications, if there's no medication chart that tells what meds other roles can use, there's no medication that can be added that a Surgeon or Paramedic can't use

Anything that isn't medications is surgery, which the Surgeon can do

I don't see anything that can be added that the Physician would be the undisputed master of, without a chart that tells so (like the Surgery chart does)

 

Fluff diseases are something very few people would take (you can see the sad Psychologist/Psychiatrist characters crying in the corner), and a development blackhole for no gain (you can pretend to have it by just saying you do, and it doesn't show up on scans)

[Roostercat]

1 hour ago, Fluffy said:

There isn't one, that's the point: Anything a Physician can do, a Surgeon can do, since the Surgeon is just a Physician with additional training ontop of it

Physicians deal in medications, if there's no medication chart that tells what meds other roles can use, there's no medication that can be added that a Surgeon or Paramedic can't use

Anything that isn't medications is surgery, which the Surgeon can do

 

hence the reason this thread was made probably

 

1 hour ago, Fluffy said:

 

I don't see anything that can be added that the Physician would be the undisputed master of, without a chart that tells so (like the Surgery chart does)

 

I am a strong advocate that the drama about charts was mostly whataboutism and not actually a problem. Of all the arguments, 90 percent of them were "what if this happens" scenarios that really didn't matter and were likely pretty easy to solve in actuality. If people can't understand a basic chart, they should re-evaluate what job they play. That said, I think a chart for this sort of thing would be fine, or harsher enforcement of lanes (ie telling surgeons to let physicians handle shit first and only step in if they arent in round or are otherwise unavailable.)

 

 

1 hour ago, Fluffy said:

 

Fluff diseases are something very few people would take (you can see the sad Psychologist/Psychiatrist characters crying in the corner), and a development blackhole for no gain (you can pretend to have it by just saying you do, and it doesn't show up on scans)

There is no real way to know for sure if people would or would not take them. And besides, having the choice is nice. As for the development blackhole, peppermint brought up fluff diseases that DO show up on scans. This would be nice and im sure its possible to do. I think calling it a development blackhole is a bit pessimistic in that regard.

[wowzewow]

Honestly, thinking about this, a lot of the problem actually just simply stems from the all-encompassing always accurate extremely adaptable Body Scanner which kinds of sucks out any and all interesting depth to the job. I've always been a staunch advocate of "Ghetto medical/Manual medical", e.g. using Stethoscope to check heartrate, penlight to check eye-damage, grab-inspecting for fractures, etc. etc. which adds a lot of opportunity to roleplay. Unfortunately this goes against the main modus operandi of medical players of "SAVE EVERYONE", and it would be an extremely unpopular nerf.

I've got some ideas for reforms for medical. It's just whether medical players are ready for it - and willing to accept it.

[HanSolo1519]

1 hour ago, wowzewow said:

snip

I think Matt's medical overhaul idea that was tossed around a bunch a couple months ago is built around this sort of thing, and a shift away from the numbers-moving cascading balancing act of baymed into something more static, since right now it is really a thin line between 'toss some bandages on and it'll disapear' and 'your round is over'

This was all thrown around months ago I can't really recall much or if it's still in the works, I just know there was a desire for this

[Roostercat]

2 hours ago, wowzewow said:

Honestly, thinking about this, a lot of the problem actually just simply stems from the all-encompassing always accurate extremely adaptable Body Scanner which kinds of sucks out any and all interesting depth to the job. I've always been a staunch advocate of "Ghetto medical/Manual medical", e.g. using Stethoscope to check heartrate, penlight to check eye-damage, grab-inspecting for fractures, etc. etc. which adds a lot of opportunity to roleplay. Unfortunately this goes against the main modus operandi of medical players of "SAVE EVERYONE", and it would be an extremely unpopular nerf.

I've got some ideas for reforms for medical. It's just whether medical players are ready for it - and willing to accept it.

As someone who plays medical, I definitely agree with this. The medical scanner is a very uninteresting way of finding problems, on top of it also presenting problems with more flavor stuff such as "welp, didnt show up on scanner!"

I think having more manual ways to figure out problems would be a net positive, both for more interesting gameplay AND more interesting roleplay. That and you can usually skip the scanner anyway if you really know the medical system.

[N8-Toe]

I agree the scanner is meh. but brainmed is LEAGUES better than old med or more static med. and the risk and death I'd call a feature, not a disadvantage. Loosing the scanner and having more indepth medical would be great, but I think it'd be a loss to loose brainmed, or a system with so many interconnected things. Death isn't a bad thing, and sometimes people are gonna die in medical.

[Sniblet]

Set Flavour Text verb but for medical scans.

Some method to cause self-damage in an OOC way, other than *succumb.

Tighten surgeons’ specialty so that they aren’t morally obligated to involve themselves in an asthma attack when physicians and paramedics are available.

There have been a few times when I’ve dragged my character at full health into an idle medbay (or mechanics workshop) and had to emote health scanner results because I could not make the game reflect what was happening. I felt disruptive and unwanted by all involved, but a big part of that issue was that doctors right now simply never do RP treatments (this being because you have to emote health scanner results), and so being RP-ill made me unique in my inconvenientness.

If RP med were made normal - starting with being enabled, rather than contradicted, mechanically - then physicians would suddenly have a lot more problems that only they are supposed to be solving.

Vampires and changelings could get SO much mileage out of this, too, not that anyone wants them to be happy.

Edited August 3 by Sniblet

[CatsinHD]

On 01/08/2024 at 16:34, HanSolo1519 said:

I think Matt's medical overhaul idea that was tossed around a bunch a couple months ago is built around this sort of thing, and a shift away from the numbers-moving cascading balancing act of baymed into something more static, since right now it is really a thin line between 'toss some bandages on and it'll disapear' and 'your round is over'

This was all thrown around months ago I can't really recall much or if it's still in the works, I just know there was a desire for this

It is currently listed as a project on the github. Iirc, Matt is focusing on getting Odyssey working and finished before working on the Medical Overhaul. So while I wouldn't encourage letting that stop all changes to medical, I also wouldn't call for drastic changes to a system that will likely be completely ripped up.

Suggestions

Anyways, some other suggestions:

• I second Sniblet's flavor text/set pose for medical scans. Allow for general and per organ and limb.
  • While not mentioned at that moment, it would be a boon for certain antags who go for more medical mystery and such
  • Could also maybe tie into autopsies, but autopsies afaik is eldritch code
• Offer some exam equipment, like reflex hammers (or shit, just let the stethoscope do it), those little ear checker things, hearing test, eye test, etc. Something to allows physicians to complete physicals (and maybe make the exam room useful).
  • This can come with an overhaul to the medical exam form if desired
• Theoretically, you could have fluff-issues that are set in character setup that can be affected by equipment in-round. Something like a stomach ache, chills, what have you. The diagnosing equipment (which would NOT be a body scanner) could be a physician-only type deal
• Give physicians equipment to diagnose infections, whether it's through blood testing or some sci-fi scanner thing. DO NOT put it back into the body scanner.
  • You can still ID infections from the symptoms, so solo/dead-med is still capable of finding it, but the physicians can do it faster, with more precision, etc.
  • You could maybe even give them some sci-fi shit that handles infections without (much) side-effects, maybe does so quickly, and give theta some nasty side-effects

These are the less intrusive/additive ideas I had. 

Body Scanner

Another thought, which is a little more to test the waters of a concept I had:

Limit what the scanner sees. The body scanner is essentially "A CT and MRI scanner shoved into one futuristic bed and console, and so much more!" (Guide to Medicine#Body Scanner). So, make things more vague. Fluff up what it reads out to you, and remove certain info. For instance, nuke anything that is found on the hand scanner. This is:

• Brain Activity
• Physicial Trauma
• Blood oxygen
• Blood pressure
• Blood Volume
• reagents present
• etc

The scanner should show ONLY:

• Internal bleeding (optional, maybe? Give some other method to detect it?)
• organ damage
• fracture
• tendons (same as internal bleeding, maybe)
• foreign objects 

With these flags, the info given should be vague rather than exact "minor, moderate, major" and stuff like that. You could even remove individual organ listings to instead have vague damage reports in the region, such as:

"Organ damage present in the Upper Body. Unsteady heart rate. Elevated blood coagulation in the Left Leg."

I'm not a medmain irl so take it as you will. Obviously in-game med mechanics shouldn't be 1:1 irl stuff, but it can help focus things.

I have some other random thoughts and ideas and such, most of them not fully formed. It sort of edges on being a med equipment rework (giving methods to detect X Y Z problem, and making the scanner just an organ and bone damage detector). To not make a long post longer, I will move on.

Finishing comment

Before I go, I will add something that applies to every department (looking at you investigators and wardens), but ESPECIALLY in medical. If another role is taking away your gameplay when they should not, such as a surgeon/paramedic handling a GTR case or an investigator/warden carrying out arrest warrants*, AHELP THAT CHARACTER. It is not allowed. I have seen plenty of players get talked to about it, and at least 2 job banned for it.

*Exceptions apply, such as when there are no physicians or no secoffs present/in-round. However, it never hurts to ask a mod or admin.