Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

Annotations declare destructiveHint=true, and the description reinforces this with 'REAL' and 'live Cliniko practice', making it clear this writes to production and is not a sandbox/dry-run. It stops short of disclosing auth requirements, duplicate-handling or idempotency behavior, so it adds meaningful value but not a full behavioral picture.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Is the description appropriately sized, front-loaded, and free of redundancy?

Three terse clauses, all front-loaded, with the write nature stated first and the required-field constraint second. Nothing is padded; the POST endpoint note is minor but harmless.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a mutation tool with a destructive annotation and no output schema, the live-write warning and required-field callout cover the essentials for correct invocation. The one gap is the absence of any mention of the return value (e.g., the created patient ID), which matters since no output schema exists to document it.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema description coverage is 100% and both required fields are already encoded via the required array and minLength, so the schema does the heavy lifting. The description's 'Requires first_name + last_name' merely restates what the schema already specifies, adding no new detail about the 9 optional fields.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Does the description clearly state what the tool does and how it differs from similar tools?

States a specific verb and resource ('creates a REAL new patient record') and a scope qualifier ('in the live Cliniko practice'). The 'WRITE' prefix and 'new patient record' cleanly distinguish it from get_patient and list_patients without needing to open any schema.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Does the description explain when to use this tool, when not to, or what alternatives exist?

The 'WRITE' marker and live-practice framing imply this is the mutation path for adding patients, giving implied usage. However, no explicit when-to-use or when-not-to-use guidance is offered, and no sibling alternative (e.g., an update/upsert tool) is named, so the routing signal is only implicit.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.