I will use the example of knights of the old republic here (not saying that it is the gold standard, just a example)
Which was based off of 3rd edition rules.
They went to far as to option up dialogue based on skill profenciencies.
I can see this opening dialogues based on background at character selection.
I do know there are spots where heal is used... but that seems to be cleric based, not spell based.
There is so much that can be done here
