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While some who follow the ways of science feel called towards the roles of alchemists and investigators, some feel compelled to practice medicine, surgery and first aid. Through rigorous studying of medical treatments, astute physicians are as capable as paladins in terms of their curative abilities, and can evaluate situations with a keen and practiced mind in many emergencies. Not to be underestimated in the heat of battle, the astute physician’s knowledge of anatomy and medicine can be a deadly tool when used offensively. (Original Concept by Tyrannical)
Primary Class: Investigator.
Secondary Class: Paladin.
Alignment: Any nonevil.
Hit Dice: d8.
Bonus Skills and Ranks: The astute physician selects three paladin skills to add to his class skills, in addition to the normal alchemist class skills. The astute physician gains a number of ranks at each level equal to 6 + Int modifier.
Weapon and Armor Proficiency: The astute physician is proficient with all simple weapons, plus the dart gun, hand crossbow, sap, sawtooth sabre, short sword, switchblade, and sword cane. He is also proficient with light and medium armor, but not with shields.
Alchemy: This is exactly like the investigator ability of the same name, except that the astute physician imbues his extracts with a touch of the divine. In addition, the astute physician adds the following paladin spells to his list of extracts at the indicated formulae levels: 1st–bless water, bless weapon, compel hostility, create water, deathwatch, detect poison, enhance water, knight’s calling, sanctify corpse, shield of fortification, virtue; 2nd–abeyance, blessing of courage and life, corruption resistance, honeyed tongue, paladin's sacrifice, veil of positive energy; 3rd–dispel magic, life shield, remove curse, remove paralysis, resilient reservoir, righteous vigor, sacred bond, shield of fortification (greater), vestment of the champion; 5th–cleanse, breath of life, crusader’s edge, life bubble; 6th–bestow grace of the champion, king’s castle, restoration (greater), sacrificial oath.
First Aid (Ex): An astute physician is beyond knowledgeable and skilled in the art of medicine, possessing a broad understanding of anatomy, surgery, and healing that far surpasses the abilities of others. An astute physician typically uses these powers to aid those who are injured, whether friend or foe, but can also use these flashes of insight to better understand their physical conditions.
An astute physician has the ability to augment condition, healing, and injury-related skill checks and ability checks through his brilliant comprehension of physiology and anatomy. The astute physician has a first aid pool equal to 1/2 his astute physician level + his Intelligence modifier (minimum 1). An astute physician's first aid pool refreshes each day, typically after he gets a restful night's sleep. As a free action, he can expend one use of first aid from his pool to add 1d6 to the result of that check, including any on which he takes 10 or 20. This choice is made after the check is rolled and before the results are revealed. An astute physician can only use first aid once per check or roll. The astute physician can use first aid on any Heal, Knowledge (nature), or Survival skill checks without expending a use of first aid, provided he's trained in the skill.
First aid can also be used on nonlethal attack rolls and saving throws against physical injuries and conditions, at the cost of expending two uses of first aid each time from the astute physician's pool. In the case of saving throws, using first aid is an immediate action rather than a free action. This ability replaces inspiration.
Infused Curative (Su): Starting at 1st level, an astute physician can channel stored alchemical energy into healing extracts that he did not prepare ahead of time. The astute physician can “lose” any prepared extract in order to create any cure extract of the same formulae level or lower (a cure extract is any extract with “cure” in its name). Creating these “cure” extracts requires 1 minute or work as normal. In addition, any “cure” extract prepared by the astute physician is considered to be created using the infusion discovery. This ability replaces trapfinding.
Contamination Resistance: This is exactly like the investigator’s poison resistance ability, except that its effect also applies to diseases. At 8th, as long as the astute physician has a point left in his first aid pool, he may grant a +4 alchemical bonus on saving throws against poison and disease to all allies within 10 feet. This ability functions only while the astute physician is conscious, not if he is unconscious or dead. This ability replaces poison resistance.
Anesthetics (Ex): At 3rd level, an astute physician learns how to supplement uses of the Heal skill with pain-killing drugs. He gains Skill Focus (Heal) as a bonus feat. Any use of the Heal skill that has a risk of harming the patient (such as extracting a barb) only deals the minimum damage when performed by an astute physician. This ability and remedy replace trap sense.
Investigator Talent: This is exactly like the investigator ability of the same name, except that the astute physician may also select from the following new investigator talents, restricted to the Astute Physician multiclass archetype. Unless otherwise noted, each investigator talent can only be selected once.
Alchemist Discovery: The astute physician may choose the following discoveries: alchemical zombie, combine extracts, dilution, elixir of life, enhance potion, eternal potion, extend potion, healing touch, infusion, mummification, preserve organs, spontaneous healing. These replace the normal alchemist discoveries that can be selected by the investigator.
Post-Mortem Research (Ex): The astute physician adds blood-biography, gentle repose and speak with dead to his list of 2nd–level formulae. He also gains a +5 competence bonus to all Heal and Knowledge checks made to determine a creature’s cause of death.
Rogue Talent: The astute physician may choose the following rogue talents: assault leader, black market connections, canny observer, charmer, coax information, combat swipe, deft palm, disease use, follow clues, guileful polyglot, grit, hard to fool, hold breath, honeyed words, iron guts, major magic, minor magic, peerless maneuver, philologist, rapid boost, resilience, scavenger, stand up, strong stroke. These replace the normal rogue talents that can be selected by the investigator.
Steady Hands (Ex): The astute physician can spend 1 point from his first aid pool to augment the result of any Disable Device, Escape Artist, Sleight of Hand, or Use Magic Device skill check.
Surgical Precision (Ex): While making an attack using a light or one handed weapon that deals piercing or slashing damage (such as daggers), the astute physician can inflict normal lethal damage when using his medical intervention ability. He can also use his first aid to augment an attack roll when using surgical precision.
Therapist (Ex): The astute physician can spend 1 point from his first aid pool to augment the result of any Diplomacy, Knowledge, or Sense Motive skill check.
Any talent that would affect an investigator’s inspiration, studied combat, or studied strike abilities instead apply to the astute physician’s first aid, medical examination, and medical intervention abilities respectively. The astute physician does not gain any additional skills added to the inspiration ability through a talent.
Pharmaceuticals (Ex): At 3rd level, an astute physician gains the Brew Potion and Craft Pharmaceutical item crafting feats as bonus feats, even if he does not meet the prerequisites. This ability replaces keen recollection.
Medical Examination (Ex): With a keen eye and calculating mind, an astute physician can assess the physiology of his opponents and allies alike. At 4th level, an astute astute physician can use a move action to examine a single enemy or ally that he can see. Upon doing so, he adds 1/2 his astute physician level as an insight bonus on melee attack rolls and as a bonus on damage rolls against enemies, and 1/2 his astute physician level as an insight bonus when using the aid another action with allies. This effect lasts for a number of rounds equal to her Intelligence modifier (minimum 1) or until she deals or heals damage with medical intervention, whichever comes first. This bonus on damage rolls is considered precision damage, and is not multiplied on a critical hit.
An astute physician can only have one target of medical examination at a time, and once a creature has become the target of an astute physician's medical examination, he cannot become the target again for 24 hours unless the astute physician expends one use of first aid when taking the move action to use this ability. This ability replaces studied combat.
Medical Intervention (Ex): At 4th level, an astute physician can choose to make a medical intervention against the target of his medical examination as a free action, upon successfully hitting an examined enemy with a melee attack, to deal additional nonlethal damage. The damage is 1d6 at 4th level, and increases by 1d6 for every 2 levels thereafter (to a maximum of 9d6 at 20th level). The damage of medical intervention is precision damage and is not multiplied on a critical hit; creatures that are immune to sneak attacks are also immune to medical intervention.
The astute physician must be able to see the target well enough to pick out a vital spot and must be able to reach such a spot. An astute physician cannot use medical intervention against a creature with concealment.
If the target of the astute physician's medical examination is an ally, she can instead heal an additional 1d6 of damage as part of an aid another action that does not provoke attacks of opportunity. The amount of damage healed increases by 1d6 for every 2 levels thereafter (to a maximum of 9d6 at 20th level). This ability replaces studied strike.
Swift Aid (Ex): At 4th level, an astute physician can create alchemical items with astounding speed. It takes an astute physician half the normal amount of time to create alchemical items. He also gains Swift Aid as a bonus feat.
Remedy (Ex): At 6th level, and every three levels thereafter (9th, 12th, and so on), an astute physician learns how to treat conditions through medical means. Whenever the astute physician uses medical intervention to heal damage to one target, the target also receives the additional effects from all of the remedies possessed by the astute physician. Remedies can remove a condition caused by a curse, disease, or poison without curing the affliction. Such conditions return after 1 hour unless the remedy actually removes the affliction that causes the condition.
At 6th level, the astute physician can select from the following initial remedies.
Bleeding: The target is no longer bleeding.
Fatigued: The target is no longer fatigued.
Sickened: The target is no longer sickened.
At 9th level, an astute physician adds the following remedies to the list of those that can be selected.
Dazed: The target is no longer dazed.
Diseased: The astute physician’s medical intervention ability also acts as remove disease, using the astute physician’s level as the caster level.
Staggered: The target is no longer staggered, unless the target is at exactly 0 hit points.
At 12th level, an astute physician adds the following remedies to the list of those that can be selected.
Addicted: The target is no longer addicted to a singular drug or substance.
Exhausted: The target is no longer exhausted. The astute physician must have the fatigue remedy before selecting this remedy.
Nauseated: The target is no longer nauseated. The astute physician must have the sickened remedy before selecting this remedy.
Poisoned: The astute physician's medical intervention ability also acts as neutralize poison, using the astute physician's level as the caster level.
At 15th level, an astute physician adds the following remedies to the list of those that can be selected.
Blinded: The target is no longer blinded.
Deafened: The target is no longer deafened.
Disabled: The target is no longer disabled.
Paralyzed: The target is no longer paralyzed.
Stunned: The target is no longer stunned.
True First Aid (Ex): At 20th level, an astute physician becomes an expert in the field of medicine. He instead adds 2d6 rather than 1d6 to the result of his skill checks augmented by first aid.
In addition, an astute physician may spend a point from his first aid pool to deliver any beneficial extract to an ally when using his medical intervention ability as the touch injection spell. If an ally is healed to full health (maximum hit points) when using medical intervention, half of any of the points of healing that would be wasted are instead gained by the ally as temporary hit points. This ability replaces true inspiration
Table: Astute Physician
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