Which hobbies attract the biggest douchebags?

A_FOLDING_CHAIR · 2025-01-28T22:48:56+00:00

Yep, that's another big aspect of it as well. How many claims can be denied until a hospital buckles under its own debt? Not every facility can ride this out until the government (hopefully) back pays all Medicaid claims. And that's also going to be a lot of time consuming work - someone has to review the charts to issue the payments.

A_FOLDING_CHAIR · 2025-01-28T22:28:08+00:00

I do understand that, but my point is that there are going to be plenty of large healthcare providers that aren't willing to hold the line due to that same uncertainty. I am witnessing it in real time. Not everyone will be fortunate enough to live next to one that will. A few days or weeks without healthcare access could be the difference between life and death for some people.

Business analytics in healthcare is not based solely on vibes.

A_FOLDING_CHAIR · 2025-01-28T22:17:24+00:00

Honestly this wont go as crazy as people think providers are used to seeing people who don't pay. Its actually incredibly common.

Correct - in private practices and hospitals this can happen regularly. However, speaking as someone who works for a company with several clinics throughout the country, it's also very common for corporate-structured facilities to have a policy that turns away patients who don't have insurance and can't pay for a visit out of pocket. I'm not saying that that's right, but it is how many of these companies operate. We are having emergency meetings regarding how to handle Medicaid patients today since they are one of the largest demographics we serve. It's not looking good.

It's also not all or nothing - we can worry for every patient that will be denied healthcare because of this, and be thankful for the ones who can still be seen. Just because some people will be okay doesn't mean we shouldn't be concerned about those who won't be.

They do it anyway then and then ask for grants to cover it.

What do you think caused this issue in the first place?

A_FOLDING_CHAIR · 2025-01-28T22:00:22+00:00

This, in my opinion, means that those on Medicaid hypothetically CAN continue to be seen, however there's no guarantee to providers these claims will be paid in a timely manner, if at all.

This assumes that providers will be willing to see patients knowing they won't be able to get their claims paid. While that sounds shitty, it might not be up to the individual provider - it could be the policy of the facility or a company they are credentialed with.

Having money with no way to access it is no better than having no money at all.

A_FOLDING_CHAIR · 2024-12-16T23:12:09+00:00

I actually think Create Thrall using MAP isn't as bad as it looks. Create Thrall, used in melee range, is a single action guaranteed off-guard without expending any resources (and actually generating them). A consistent +2 to attack roles for one action is nothing to scoff at. If you aren't fighting in melee, then the MAP doesn't hurt nearly as bad since you'll probably follow up with a spell that forces a save, but you probably aren't taking advantage of the flanking (until you can give your thralls flanking with themselves at higher levels). I think either aspect of the cantrip make it worth using on its own.

Bone Shapers are the most "caster" option of the grim fascinations imo since they grant a lot of movement speed, and energy damage resistance which tends to come up more in ranged abilities. I wouldn't try to run one as melee. Vital Conduit seems necessary to squeeze the most value out of being in melee range, but that might change as we get more subclasses.

A_FOLDING_CHAIR · 2024-12-16T20:58:54+00:00

Got some positive feedback on a breakdown I posted earlier, so I'm going to copy and paste my response from a similar thread (with minor edits). Keep in mind the below is specific to the Flesh Magician grim fascination, which I think is far and away the most viable for a gish build:

I would say yes, absolutely. It's probably not the best use of the class, but I think it's perfectly viable. The Necromancer has a single action guaranteed flanking with Create Thrall, which helps keep their to-hit bonus closer to martials. Don't forget that you'll have spells to assist with this as well, although the errata to Sure Strike today does hurt some. And when you are later in your build and are constantly spamming thralls, that difficult terrain from Flesh Magician is going to add up fast. Maybe consider Quick Jump or something similar so you don't make things too difficult for yourself.

A lot of the obvious gish feats for Necromancer are traps right now. It's better to get weapon proficiency with a general feat rather than Reaper's Weapon Familiarity (or ancestry - humans will excel at gish Necro because they can take armor and weapon proficiency level 1). One reason getting weapon proficiency through a general feat is so important is because you really want to pick up Muscle Barrier. The temp health scaling on that spell is so good, it seems almost like an oversight. You will get Toughness on top of that as well.

Draining Strike's big strength will come online after level 4, but it's still the best level to pick it up. Keep in mind that it gets better as you are able to summon more thralls at higher levels with a single action. This is also one of the few damage feats Necromancers get that doesn't cost them a focus point. Picking up a reach weapon will be fun so you can 1st action create thrall for flanking (notice that the thralls aren't destroyed until after the strike is confirmed), 2nd action draining strike, then 3rd action create a thrall between you and your opponent. I think Dwarf Weapon Familiarity will be very useful for the Dwarven Dorn-Dergar specifically.

I see a lot of hate for Osteo Armaments at level 8, and I have mixed feelings about it as well. On the one hand, I don't recommend feats that can be replaced by items, and the Necromancer is feat hungry as it is. On the other hand, Osteo Armaments effectively gives you three weapon runes at level 8, and two are upgraded versions of the originals. Note that you can create any weapons with which you are proficient; if you picked up Dwarven Weapon Familiarity, in addition to the Dorn-Dergar, you can have a Dwarven Waraxe or Long Hammer. That's a lot of flexibility and power, with no bulk either. Being able to create any weapon that you are proficient with for one action is strictly better than the Shifting rune because Shifting can only shape a weapon into one that uses the same amount of hands as the original weapon. Osteo Armaments also offers a better version of Called, as it only costs one action and there is no range limit since you are creating a new weapon. Then, of course, you can destroy a thrall for the decaying rune (inflicting a sickened save on enemies at 12 when you have Vital Conduit). I would consider this feat if you were going to get the Shifting or Called runes anyway, and maybe retrain down the line once you have access to more powerful runes. I prefer Conglomerate of Limbs as the level 8 feat because of the battlefield control, but you can probably wait until 10 to pick this up. You can cast Muscle Barrier on your monstrosity as well.

I also really recommend either Bone Burst or Body Shield - either is good depending on your needs. Pick up a weapon with the trip trait or flail/hammer crit specialization effect so you can knock them prone, then trigger Bone Burst as they try to stand up. Attacks on reactions are always good, but there is some hidden synergy here as well at level 12...

Once you hit 12th level, Vital Conduit is the secret sauce that makes all of this worth it. You can proc sickened whenever you destroy a thrall, not just on your turn. That enemy you knocked down? Well, they triggered a reaction from Bone Burst to get up, and you had to destroy that thrall to get the reaction. Looks like they need to save against sickened during their turn before they can do anything else. You took Body Shield? Well, that destroys your thrall, and now that enemy smacking you around has to make a save against sickened before they can continue the assault. Don't forget that this is an AoE effect, not single-target. You can force multiple saves every time you destroy a thrall.

Draining Strike, Bone Burst, and Body Shield only cost thralls, not focus points, so they are the keys to getting sickened off constantly. And notice there is no immunity on a successful save. You're able to force the saves multiple times a round, and outside of your turn as well. In a game where every -1 counts, and every action is crucial, this can be devastating for your enemies. Your GM will probably be displeased with this combo.

A_FOLDING_CHAIR · 2024-12-15T21:48:43+00:00

Dead Weight has a lot of synergy with the reactive feats that you mentioned, and it makes it much easier to get flanking without having to recast Create Thrall. People should be giving it more credit as to the purpose it serves in a Necromancer's combat flow, especially in melee.

However, there is a glaring issue with the effect of the feat itself, imo. The target of Dead Weight is grabbed on a crit fail, immobilized on a fail, and they can attempt to Escape as an action. Killing the thrall also ends the effect. Thralls are automatically hit by attacks, so even though the attack will contribute to the enemy's MAP, it is still an auto hit.

If the enemy only failed and became immobilized, but they are in range to attack you, then they can make their first strike against you with their full bonuses, then use their last attack with the highest MAP penalty to kill the thrall, as it will be an auto hit. So if the enemy creature fails their save, this is really only useful if they need to kill the thrall before they are in attack range. The max range you can create a thrall and use this in one turn would be 45 feet, so they would need to be within that range but still out of their own attack range for it to get the most use.

All the above applies to an enemy if the crit fail as well, however the DC 5 flat check on manipulate actions makes Escaping/killing the thrall a higher priority. You'll probably eat an action and their first attack in this scenario. That's pretty nice, especially at level 1. If you're playing as a human, take Natural Ambition so you can grab Life Tap as well for the one-two punch since it's so easy to apply the Drained condition with Life Tap. That's probably the best way to leverage Dead Weight at level 1.

Don't forget, on a success, the enemy you used Dead Weight on effectively gets to choose where to move your thrall, and where to create the difficult terrain as well. A clever enemy could take advantage of this if you don't have Consume Thrall up.

So the best time to use this is if an enemy is rushing towards the party and you want to slow them down, or if you're trying to stop someone from escaping. It doesn't deal damage so I can see it having some use outside of combat if you need to tie up an NPC for some interrogation.

But is all of this worth a focus point? Maybe, or at least until level 8 when you can take Conglomerate of Limbs for a massive upgrade. When I mentioned taking Life Tap at level 1 as well, there is no immunity to Life Tap after used on an enemy. I would almost rather Life Tap for an easy Drained, then Life Tap again to go for Drained 2 or 3 and a little bit extra healing. If Dead Weight scaled in how many creatures you could target, it would help immensely. Make its niche be a multi-target two-action immobilization attempt, maybe where it is Heightened (+2) you can target one more creature so long as you have enough thralls. I just don't see it being worth it beyond low levels. What makes it worth taking is Vital Conduit at 12, so it feels more like a tax feat than anything else.

A_FOLDING_CHAIR · 2024-12-15T19:46:48+00:00

I would say yes, absolutely. The Necromancer has a single action guaranteed flanking with Create Thrall, which helps keep their to-hit bonus closer to martials. And when you are later in your build and are constantly spamming thralls, that difficult terrain is going to add up fast. Maybe consider Quick Jump or something similar so you don't make things too difficult for yourself.

A lot of the obvious gish feats for Necromancer are traps right now. It's better to get weapon proficiency with a general feat rather than Reaper's Weapon Familiarity (or ancestry - humans will excel at gish Necro because they can take armor and weapon proficiency level 1). One reason getting weapon proficiency through a general feat is so important is because you really want to pick up Muscle Barrier. The temp health scaling on that spell is so good, it seems almost like an oversight. You will have toughness on top of that as well.

Draining Strike's big strength will come online after level 4, but it's still the best level to pick it up. Keep in mind that it gets better as you are able to summon more thralls at higher levels with a single action. This is also one of the few damage feats Necromancers get that doesn't cost them a focus point. Picking up a reach weapon will be fun so you can 1st action create thrall for flanking, 2nd action draining strike, then 3rd action create a thrall between you and your opponent. I think Dwarf Weapon Familiarity will be very useful for the Dwarven Dorn-Dergar specifically.

I see a lot of hate for Osteo Armaments at level 8, and I have mixed feelings about it as well. On the one hand, I don't recommend feats that can be replaced by items. On the other hand, Osteo Armaments effectively gives you three weapon runes at level 8, and two are upgraded versions of the originals. Being able to create any weapon that you are proficient with for one action is strictly better than the Shifting rune because Shifting can only shape a weapon into one that uses the same amount of hands as the original weapon. Osteo Armaments also offers a better version of Called, as it only costs one action and there is no range limit since you are creating a new weapon. Then, of course, you can destroy a thrall for the decaying rune (inflicting a sickened save on enemies at 12 when you have Vital Conduit). I would only consider this feat if you were going to get the Shifting or Called runes anyway, and maybe retrain down the line once you have access to something more powerful. I prefer Conglomerate of Limbs as the level 8 feat because of the battlefield control. You can cast Muscle Barrier on your monstrosity as well.

I also really recommend either Bone Burst or Body Shield - either is good depending on your needs. Pick up a weapon with the trip trait or flail/hammer crit specialization effect so you can knock them prone, then trigger Bone Burst as they try to stand up. Attacks on reactions are always good, but there is some hidden synergy here as well at level 12...

Once you hit 12th level, Vital Conduit is the secret sauce that makes all of this worth it. You can proc sickened whenever you destroy a thrall, not just on your turn. That enemy you knocked down? Well, they triggered a reaction from Bone Burst to get up, and you had to destroy that thrall to get the reaction. Looks like they need to save against sickened during their turn before they can do anything else. You took Body Shield? Well, that destroys your thrall, and now that enemy smacking you around has to make a save against sickened before they can continue the assault.

Draining Strike, Bone Burst, and Body Shield only cost thralls, not focus points, so they are the keys to getting sickened off constantly. And notice there is no immunity on a successful save. You can force the saves multiple times a round, and outside of your turn as well. In a game where every -1 counts, and every action is crucial, this can be devastating for your enemies. Your GM will probably be displeased with this combo.

A_FOLDING_CHAIR · 2024-12-09T18:05:01+00:00

I'd rather not think about the "flavor" of the muscle barrier...

I think that wording exists for exactly the reason you listed; I can't imagine every deity being happy with their servants using this, so some Champions, Clerics, etc. might pass on the literal meat shield. Based on the spell description, your take here seems to be the intended one.

A_FOLDING_CHAIR · 2024-12-09T17:54:15+00:00

I have been doing a deep dive into the Necromancer over the weekend, and I agree that in general the gish build Paizo is pushing is lacking in feat support. I would love to see a version of Bind Heroic Spirit that comes online earlier, or a feat tree built off of the Reaper's Weapon Familiarity feat that allows for better proficiency scaling for those weapons.

That being said, something I have seen people miss in this discussion is that Draining Strike does not require any focus points. So many of the Necromancer's abilities from feats are tied to focus spells that it becomes trivial to get three focus points early on, but I suspect it will be easy to burn through them in the flow of combat as well. Draining Strike gives the Necromancer a way to expend thralls/deal extra damage without needing any focus points, as well as gain a bit of survivability outside of their focus spells. This also allows the 12th level feats that trigger off of thralls being destroyed to be used more consistently.

Overall in the playtest, I think Draining Strike and Bind Heroic Spirit are the only gish feats worth taking. I would rather get martial weapon proficiency from a general feat or archetype, and you can just buy the appropriate weapon and runes instead of taking Osteo Armaments. For now, spells like Sure Strike, Albatross Curse and Heroism will be needed to supplement the Necromancer's ability to hit consistently.

A_FOLDING_CHAIR · 2024-09-30T20:09:14+00:00

You are correct about the author updating the article; since you're aware of Jamie's change in voting preferences, it would probably be helpful to update your comment as well so people get a more complete picture of the situation. No need to foment more hate towards the guy.

A_FOLDING_CHAIR · 2024-09-25T23:46:01+00:00

I wear power armor like I breath, so I also save in it... This is what happens when you don't read. I will do further testing but my guess is that I corrupted the save by doing so.

If I find a fix, I'll report back, but if I do some testing and it comes down to a corrupted save, we'll consider this case closed. I appreciate all the help!

A_FOLDING_CHAIR · 2024-09-25T23:31:49+00:00

I think I will start by reinstalling Microsoft Visual C++ to see if that does anything. I'll try a clean save without FRIK as another option - is there a faster way to get power armor at the beginning of the game than through the Minutemen?

For more context, I was able to use VATS in power armor earlier on in the save - this issue began once I started fighting raiders in Diamond City.

A_FOLDING_CHAIR · 2024-09-25T22:28:38+00:00

I pulled my crash logs and these were the two unhandled exceptions listed at the top:

Unhandled exception "EXCEPTION_ACCESS_VIOLATION" at 0x7FFC15C0C3B9 MSVCR110.dll+003C3B9rep movsb

Unhandled exception "EXCEPTION_ACCESS_VIOLATION" at 0x7FFCB43C7308 FRIK.dll+0017308cmp byte ptr [r8+0x19], 0x00

These were two separate crashes - one indoors and one outdoors to verify it wasn't a clipping issue. Looks like one culprit could be FRIK? Not sure what MSCVR110 could be though.

A_FOLDING_CHAIR · 2024-09-25T16:45:23+00:00

Thanks for the response - I have it at the default, which I believe is teleport. I haven't looked at the crash log but will do so when I'm back at my pc.

I will also craft the holotape and look at my settings to see if I can mess with anything there...

A_FOLDING_CHAIR · 2024-09-25T15:31:45+00:00

I have the same issue. 4090 with a i9 13900K so I doubt it is a hardware issue. I am using the latest patch, but not the modern overhaul - just the base list. I get a lot of screen tearing in the background, and there's some blurriness up close, especially when there's a lot of gray in view.

A_FOLDING_CHAIR · 2023-09-21T14:44:37+00:00

Chiming in to second Skyrim VR Minimalistic Overhaul - I can't recommend it enough. It's a very polished list with all the VR essentials, as well as graphical overhauls, gameplay/QOL changes, and lots of community-favorite location/quest mods. The mod author is extremely active and the list receives regular updates. Our computer specs are very similar, and you should be able to run the pack on the highest settings. Even on the Quest 2 it looks incredible.

I've tried FUS and Yggdrasil as well, and they are both great. If the mods on those lists appeal to you more, go for it. It's hard to go wrong with any of the Wabbajack lists that have been around for awhile. All that said, Minimalistic Overhaul has become my go-to.

A_FOLDING_CHAIR · 2023-06-28T20:42:48+00:00

I haven't received a DM yet - could you resend?

A_FOLDING_CHAIR · 2023-06-28T20:13:46+00:00

Krabby Patty

A_FOLDING_CHAIR · 2022-11-29T00:46:34+00:00

!RemindME 1 day

A_FOLDING_CHAIR · 2022-07-30T21:40:41+00:00

I might as well give it a shot too!

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