Most physicians in Komaru are either members of the Church of Inner Light or the merchant Physician's Guild. In both cases, a physician's training takes upwards of ten years. Renegade physicians do exist, and are often associated with the Komaran drug trade. In a rare show of unanimity, the Church and the Physician's Guild cooperate in eliminating these dangerous individuals. All types of physicians use a combination of medical knowledge and what can only be described as magic to heal their patients; merchant and Church physicians principally differ in philosophy, not technique.

Physicians play an important role in Komaran culture at several levels. For the majority of society, they are tireless servants of the public good, endlessly treating injuries, curing disease, and healing the ailing. To a peasant or artisan, fifteen minutes of a physician's time can mean the difference between life and death. Because of this, physicians are treated with respect, but are often also threatened by overwrought commoners who demand their immediate attention.

When treating commoners, physicians are generally called upon to exercise two skills: pharmacy and healing. As pharmacists, most physicians are trained to recognize and identify a variety of drugs and poisons. They use this knowledge to cure disease, poisoning, and recreational overindulgence. As healers, physicians use their mystical talents to close and heal wounds. Wounds treated by physicians are best described as sealed. While the wounds themselves are eliminated, a physician's techniques leave colored marks upon and beneath the subject's skin. Like bruises, these marks slowly fade over about the same amount of time a wound would need to close naturally. In certain communities, physician's mark is seen as a sign of great wealth or connections, and some decadent nobles are even said to use physician's mark as a sort of cosmetic.

Among the nobility, access to a physician is a luxury associated with rank. Any proper noble about the rank of viscount is expected to have a personal physician on their staff. In practice, most counts share a physician with one or more of their peers, an arrangement that is even frequent among the lower-ranked nobility. In addition to their other duties, physicians also possess a special power over the nobility: they are the keepers of the noble bloodlines.

Normally, when infants are born, a trained physician is briefly able to observe the actual makeup of the child's bloodline as a tangle of 'threads' of spectral light. These threads combine the father and mother's bloodlines into a pattern uniquely the child's, and can be made visible to a physician shortly after the child leaves the womb, until some time after birth. Physicians can do two things with the different threads: merge identical threads, or cut threads. Merging is easier, and keeps bloodline expression relatively pure by simplifying the work of later physicians. Only skilled physicians can cut more than a single bloodline thread during a birth, but once cut, the child will not inherit the thread.

Because of this ability, most nobles attempt to have a physician oversee their children's births. While not possible for every birth, the activities of physicians have kept most nobles' bloodlines to under several dozen threads. In contrast, commoners tend to have hundred or even thousands, making the bloodlines of nobles' illegitimate children by commoners nightmarishly impure.

Fortunately, because of another ability physicians possess, this is not as common an event as it could be. With a few minutes of effort, a trained physician can still a woman's natural cycle, preventing her from being able to become pregnant. The process takes the same amount of time to reverse, and is generally used by most noble women and many wealthy members of the merchant class. Many physicians have attempted to discover a similar technique for use on men, but so far there has been no success.