When Jim Trounson founded Medical Management Inc. in 1977, the main office was near Downtown Boise. But the company went digital 10 years ago. Now corporate headquarters are wherever Trounson happens to be, whether he's riding his bike on the Greenbelt or touring France with his wife.

His company has used technology to upend its business model, cutting costs and overhead while allowing employees to integrate work and leisure into a seamless continuum.

The Boise company manages 17 hospitals and clinics in the Northwest, including Alaska.

In 1999, MedMan closed its office and began operating in the virtual world, saving $15,000 a month, shredding eight Dumpsters' worth of paperwork. Trounson and his team run the company from anywhere in the world using laptop computers and smartphones.

Trounson says trying to separate our lives into distinct categories and to schedule each category separately is crazy-making.

"Balance is bunk," he says.

A BLENDED LIFE

Last summer, he proved the point when he and his wife took a two-week bike tour of Normandy.

"I did everything on my PDA," he said. "None of our clients even knew I was out of the country. Stress doesn't come from work, it comes from being out of control."

Still based in Boise, the MedMan corporate team maintains a small meeting space Downtown. The office is no bigger than an average bedroom but is outfitted with a 50-inch video monitor for teleconferencing, a half-dozen easy chairs with integrated desktops, and a Pleo robotic dinosaur for entertainment.

"That is the extent of our overhead, so we're extremely profitable," Trounson said.

But with the corporate team taking advantage of the virtual office, the space doesn't get much use.

Office administrator Monica Gabby is expecting her second child at the end of June, but her doctor ordered her to bed three weeks ago. She's transformed her bedroom into an office and maintains her duties as human resources manager and controller while propped up on pillows.

She's been with MedMan for five years and loves the fact that she can be home with her 2-year-old, and be working, all while she's restricted to her bed.

"I can prop myself up for a few hours in the morning, and then I have to be horizontal and rest for a while," she said.

Because Gabby can stretch her work hours into the evening, or the weekend, she can work at times that are most productive for her. For instance, she will have to present the monthly financial results to the board next week.

"I'll be preparing for that this weekend, but I'll also be taking a few afternoon naps, not something I could do in a traditional office," she said.

MedMan operations director Nicole Brown said she was frustrated by her work in a traditional clinic where she felt like she was "warming a chair for eight hours" while her children were growing up without her.

"I wanted to volunteer and make it to their programs, and despite a supportive employer, it was very hard," she said.

Although she spends daylight hours with her kids, Brown said she thinks she's more productive than if she worked a traditional eight-hour day.

"I put more hours and effort into this job because I can dictate when I do it," she said. "You make gains on the margins. I can get an hour or two done instead of getting dressed and commuting in the morning."

She and corporate recruiter Molly Ramsay, who is on sabbatical, recently completed a successful deal while Ramsay was beginning a hike in the Arctic.

"We happened to be recruiting two superb candidates while I was on vacation, and our top choice backed out," said Ramsay. Ramsay was able to finish her investigation of the next candidate from Fairbanks and negotiated the deal with the candidate via cell phone from the trailhead on the Yukon River.

"So over two days, things fell apart and were recovered, and the client didn't suffer because I was on vacation," she said.

BUSINESS MODEL: NEW VS. OLD

Trounson says flexibility has been key to his ability to hire outstanding people.

"Our corporate staff has such varied lifestyles," he said. "They like working for a company where they don't have to dress, commute and sit at a desk. This is just a healthier lifestyle."

Trounson, 67, and a fourth-generation Idahoan, managed military hospitals in Germany and Vietnam before coming home to work in Salmon, then Boise, where he decided the more usual way of managing medical groups wasn't working well.

Traditionally the owners, typically a group of doctors, hire an individual to manage the office - a business manager, executive director, administrator, they go by different titles - and hope that works out.

It often doesn't, first because people tend to leave every five years on average.

"It can be devastating for a group to lose all that institutional knowledge, and momentum," Trounson said.

The profession also has gotten far too complex for one person to manage, said Liz Johnson, spokeswoman for the Medical Group Management Association, which represents administrators, CEOs, physicians in management, board members, office managers and other management professionals.

"From malpractice and employment law, to HIPAA compliance or the toilet just exploded, as medicine becomes more complex, it is very difficult if not impossible for an in-house administrator to deal with it all," she said.

MedMan provides clients with a professional manager on-site but also backs them up with a staff of professionals with expertise in health law, coding, finance and marketing, among other services.

"I like what Churchill said about management," Trounson said. "Don't put your experts on top, put them on tap. You don't want a computer nerd bossing people. But you want him available to the bosses, the generalists who we put on site, and turbocharge them with experts."

MedMan has 17 clients ranging in size from a small rural clinic in Bend, Ore., to hospital groups with multiple clinics and 60 or more physicians.

MedMan's sales grew 88 percent in 2008 and doubled in the first quarter of 2009. And the virtual business model makes the company more competitive.

"When we go out to bid against national companies, we come in at about 35 percent because our overhead is a fraction of theirs and we have such an efficient model," Trounson said.

Brad Talbutt: 672-6737