Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?
Annotations already declare readOnlyHint, idempotentHint, and non-destructive behavior. The description adds that patients are 'public no-PHI', which is useful data-sensitivity context but not a rich behavioral trait like auth requirements or side effects. With annotations covering safety, a score of 3 is appropriate.
Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.