Train It Once, Run It Forever: 10 Steps to a Claude That Works For But Without You
I write a medical study summary for ObGyn Intelligence roughly twice a week. The format is always the same: title line, 150-word summary, 150-word “What it means,” 150-word “My Take.” Seventh-grade readability. No jargon. Output as a Word document.
I used to type these instructions every time. Then I realized I was doing what I tell my residents never to do—repeating a task manually when a system could handle it. So I built a Skill. Now I say “Summ,” attach a PDF, and Claude produces the finished summary without a single additional instruction.
Every time.
Exactly right.
Skills, Cowork, and Scheduled Tasks are the features that let Claude work without you standing over it.
Here are 10 steps to set them up.
The 10 Steps
The rest of this post is for paid subscribers
Quick reminder on how to access Claude Cowork:
Go to claude.com/download. Download the app on your computer.
You must have a Pro account ($20/month). I pay for the $100/month plan.
Open the app. Click on the Cowork tab at the top between Chat & Code.
Select a folder from your computer. More about it right after this set up.
Make sure to always select “Opus 4.6” for complex tasks. It’s the smart model.
Step 1: Understand what a Skill is. A Skill is a set of detailed instructions that lives inside Claude and fires automatically when triggered. It is like a standing order in medicine. You do not re-write the insulin sliding scale every time—the standing order exists, the nurse follows it. A Skill works the same way. You define the task once, including the trigger, the format, the output, and the rules. Claude follows the standing order every time it is triggered.
Step 2: Identify your first Skill candidate. Think about the task you do most often with Claude. The one where you give the same instructions repeatedly. Summarizing articles. Drafting patient letters. Reviewing a study design. Writing social media posts about your practice. Whatever it is, if you have typed the same instructions more than twice, that task should be a Skill.
Step 3: Use Skill Creator to build it. You do not need to write code. Claude has a built-in Skill Creator that interviews you.
Open Cowork and type “Create a new skill.”
Claude will ask you questions:
What should this skill do? When should it trigger? What format should the output use? What rules should it follow? Answer the questions in plain language. Claude builds the Skill from your answers. It writes the instruction file for you.
Step 4: Define your trigger word. Every Skill needs a trigger—a word or phrase that tells Claude to activate it. Make it short and specific. Mine is “Summ” for study summaries. Another is “NotesMeme” for creating quote graphics. Choose something you will not accidentally type in normal conversation. When Claude sees the trigger, it stops asking questions and starts executing.
Step 5: Write the negative triggers. This is the part that separates a good Skill from an annoying one. Negative triggers tell Claude when NOT to use the Skill. Without them, Claude may fire the Skill when you did not want it. If your Skill summarizes studies, tell it: “Do NOT use this skill when the user is asking a general question about a medical topic. Do NOT use when no PDF is attached.” Negative triggers prevent the Skill from hijacking conversations where it does not belong.
Step 6: Test the Skill with a real example. Attach a PDF or provide the input the Skill expects. Use the trigger word. Check the output. Is it the right length? The right format? The right tone? If not, go back and refine the Skill instructions. The first version is never perfect. The third version usually is.
Step 7: Open Cowork for multi-step tasks. Skills handle single, repeatable tasks. Cowork handles complex workflows. Cowork is Claude with access to a folder on your computer. It can read your files, create new documents, run calculations, and execute multi-step tasks without you guiding each step. If Skills are standing orders, Cowork is an attending running the service. You give the objective. It figures out the steps.
Step 8: Give Cowork a folder to work in. When you open Cowork, it asks you to select a folder on your computer. This is its workspace. Put the files you want it to work with in that folder—data sets, drafts, protocols, templates. Cowork reads them, processes them, and saves its output back to the same folder. You do not need to copy and paste anything in or out of the chat window. The work happens directly on your files.
Step 9: Set up a Scheduled Task. If you have a task that should run at the same time every day or week, Claude can schedule it. Open Cowork and say “Create a scheduled task.” Tell it what to do and when to do it. Example: every Monday morning, scan a specific folder for new PDFs and produce a summary document. As long as your computer is running, the task executes on schedule. You walk in and the work is already done.
Step 10: Build your second and third Skills. After your first Skill works, build another. And another. Each one removes a repetitive task from your workflow. I have Skills for study summaries, peer reviews, CDC data analysis, LinkedIn posts, and visual abstracts. Each one took about 15 minutes to build. Each one saves me 30 minutes or more every time it runs. After a month, the compound effect is substantial. You are not working harder. You are working once, and the system runs.
My Take
The difference between using Claude as a chat window and using it with Skills is the difference between dictating every order verbally and having a functioning EMR with order sets. Both get the job done. One of them scales.
I produce roughly eight times more content now than when I was still seeing patients. That is not because I work eight times harder. It is because the repetitive parts—formatting, structuring, finding the right template—are handled by Skills I built once and have not touched since. My time goes to the part that requires a physician: reading the study, forming the opinion, making the clinical judgment.
If you completed the steps from the previous post—the Project, the about-me file, the instructions—you already have a Claude that knows you. Now make it work for you. Build one Skill this week. You will build five more by the end of the month.