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

Annotations already declare readOnlyHint=true, and the description adds genuinely useful context beyond that: the PHI handling warning, which is material for an agent dealing with protected health records. It also cites the underlying endpoint GET /treatment_notes. It doesn't disclose return shape or pagination behavior, but the PHI caution is real added value.

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 short sentences, front-loaded with the core action and the important PHI caveat. Slight redundancy in restating "Read-only" (already in annotations) and the raw endpoint, but nothing is bloated.

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 simple 3-parameter list tool with no output schema, the description covers purpose, filter scope, safety and PHI handling. It omits any hint of return format or pagination, but the annotations and schema carry most of the remaining burden.

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%, so page, per_page and patient_id are already documented in the schema. The description only restates the patient filter, adding no syntax or format detail beyond the structured data, so the baseline 3 applies.

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 ("List treatment notes") and notes the optional patient filter. It is distinguishable from the singular sibling cliniko_get_treatment_note, though it doesn't explicitly contrast with it.

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?

Implies usage via "optionally filtered by patient," telling the agent it can scope the list. There is no explicit when-to-use vs alternative guidance (e.g. list-all vs get-one), leaving the sibling routing to inference.

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