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It would work if you dropped turn based combat for real time action and made all wild pokemon appear in the over world, but actually made them do things like scavenge for food or hide.
Rare and powerful pokemon would be rare and powerful because only a limited number of them could spawn at any given time, they would spawn in areas that would be difficult to get to and hard to wait around in, and they would have a long respawn timer.
Trading and breeding would have to be altered.
Only certain pokemon can be traded because rare pokemon are regulated or something. Restrictions would be lifted if it's two high level players trading pokemon they both have caught.
The player themselves can only breed after leveling their breeding skill to a high lvl by training under an npc and completing quests.
There would be an npc league and a player league so that casuals can have a fun pve experience and comp fags can be autistic.
There wouldn't be an overarching story. The player simple travels around whatever region and gets involved in whatever is happening in in each area they go to, which would hopefully make the world feel larger. There could be a villain team, it would be like gen 1 team rocket but without Giovanni. The antics of this group would only be loosely connected though.
Occasionally there would be server wide events that require the players to work together to accomplish a goal.
It wouldn't be linear either. The main path between towns and cities wouldn't be blocked or would have detour routes to go through because something is blocking the main path. If a new player wanted to they could visit every town or city, except ones that are exclusively for high lvl players, without entering a single pokemon battle. Pokemon could scale to around your lvl everywhere in the region allowing for non-linear progression, then once a player has all the gym badges they get to start entering high lvl areas where pokemon don't scale.