This is a fantastic thread on HP and how players react to taking damage vs mechanical consequences to taking damage.

It& #39;s pretty much where my head is at regarding the two. https://twitter.com/DichotomusPrime/status/1286662348980330496">https://twitter.com/Dichotomu...
To expand a bit, my thoughts are that if you want to have mechanical consequences for getting hit by an enemy during battle ( sprains, broken bones, losing limbs, shock, etc ): don& #39;t mix that with HP, like at all.
Instead build a system where hitting someone with a ranged attack is _hard_, but _deadly_ ( or at least, quickly incapacitates someone ). Same thing for melee, make it a back and forth that ends with one person trying to deal with suddenly have a sword through their middle.
But I think we all understand that spending twenty rounds not hitting your target is absolutely not fun. It& #39;s why 5E has bounded accuracy: so that you hit more often and feel more engaged.
But I think this is where it& #39;s on the GM of the game to work with the players. Suggest tactics and strategies to the players. "Hey, if you get to higher ground, and take a round to aim you& #39;ll get a 30% bonus to that shot"
At the end of the day, GMs are part arbiter of rules, part colour commentary -- we& #39;re here to turn those (honestly kind of boring) dice rolls into feats of daring do and nail-biting near misses. So that no matter what system you& #39;re using the whole experience is fun and engaging.
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