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Held for Sale and Discontinued Operations - Additional Information (Details) $ in Thousands |  |  | 6 Months Ended | 12 Months Ended
--- | --- | --- | --- | ---
Jun. 19, 2019 USD ($) | Dec. 05, 2017 | Jun. 18, 2019 USD ($) clinic | Dec. 31, 2019 USD ($) | Dec. 31, 2018 USD ($) | Dec. 31, 2017 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |  |  |  |  |
Proceeds from sale of DMG division | $ 4,465,476 |  |  |  |  |
Proceeds from Divestiture of Businesses, Net of Cash Divested | $ 3,824,509 |  |  |  |  |
Payments to Acquire Businesses, Gross |  |  |  | $ 100,861 | $ 183,156 | $ 803,879
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 |  |  |  | 98,836 | 176,161 | 308,550
DMG Acquisitions | Series of individually immaterial business acquisitions |  |  |  |  |  |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |  |  |  |  |
Number of businesses acquired | clinic |  |  | 2 |  |  |
Payments to Acquire Businesses, Gross |  |  | $ 2,025 |  | 6,995 | 135,416
Business combination, deferred purchase price |  |  | $ 212 |  | 1,142 | 1,038
Business combination, deferred purchase price and liabilities assumed |  |  |  |  |  | 10,145
Discontinued Operations, Held-for-sale | DMG - Held for sale |  |  |  |  |  |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] |  |  |  |  |  |
Business acquisition, effective date of acquisition | Jun. 19, 2019 |  |  |  |  |
Purchase And Sale Agreement Aggregate Purchase Price | $ 4,340,000 |  |  |  |  |
Business Acquisition, Date of Acquisition Agreement |  | Dec. 05, 2017 |  |  |  |
Loss on sale of discontinued operations before taxes |  |  |  | $ (23,022) | $ 0 | $ 0

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