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Held for Sale and Discontinued Operations Additional Information (Details) $ in Thousands | 3 Months Ended
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Mar. 31, 2019 USD ($) clinic | Mar. 31, 2018 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |
Payments to Acquire Businesses, Gross | $ 11,274 | $ 16,582
Series of Individually Immaterial Business Acquisitions |  |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |
Payments to Acquire Businesses, Gross | $ 10,210 |
Series of Individually Immaterial Business Acquisitions | DMG held for sale |  |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |
Number of businesses acquired | clinic | 1 |
Payments to Acquire Businesses, Gross | $ 1,064 |
Business Combination, Consideration Transferred, Other | $ 105 |
Discontinued Operations, Held-for-sale | DMG held for sale |  |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |
Contractual Termination Date | Jun. 30, 2019 |

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- Definition Amount of tangible or intangible assets, including a business or subsidiary of the acquirer transferred by the entity to the former owners of the acquiree. Excludes cash. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 50 -Paragraph 1 -Subparagraph (b)(2) -URI http://asc.fasb.org/extlink&oid=35744584&loc=d3e6927-128479 + Details
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