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Business Segments (Segment Reporting Information) (Details) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended 12 Months Ended
Dec. 31, 2013
Sep. 30, 2013
Jun. 30, 2013
Mar. 31, 2013
Dec. 31, 2012
Sep. 30, 2012
Jun. 30, 2012
Mar. 31, 2012
Dec. 31, 2013
segment
Dec. 31, 2012
Dec. 31, 2011
Segment Reporting Information                      
Revenues $ 423,598 $ 421,491 $ 407,864 $ 379,044 $ 369,441 $ 363,882 $ 256,386 $ 148,277 $ 1,631,997 $ 1,137,986 $ 515,584
Gross profit 129,753 127,210 121,332 110,111 112,054 112,213 81,509 50,117 488,406 355,893 177,688
Operating Income                 123,968 81,181 38,633
Amortization of intangible assets                 21,751 18,016 2,346
Assets 1,261,194 [1]       1,114,463 [1]       1,261,194 [1] 1,114,463 [1] 427,267 [1]
Reportable segments (in number of segments)                 4    
Apex
                      
Segment Reporting Information                      
Revenues                 942,463 508,743  
Gross profit                 258,150 140,669  
Operating Income                 76,971 36,416  
Amortization of intangible assets                 19,524 15,665  
Assets 656,733 [1]       642,594 [1]       656,733 [1] 642,594 [1]  
Oxford
                      
Segment Reporting Information                      
Revenues                 412,189 363,765 279,643
Gross profit                 143,334 127,895 99,187
Operating Income                 58,990 56,289 37,676
Amortization of intangible assets                 965 437 821
Assets 365,118 [1]       235,099 [1]       365,118 [1] 235,099 [1] 221,690 [1]
Life Sciences
                      
Segment Reporting Information                      
Revenues                 171,518 162,799 155,324
Gross profit                 56,308 55,874 52,643
Operating Income                 28,354 25,632 24,883
Amortization of intangible assets                 429 807 901
Assets 128,824 [1]       150,696 [1],[2]       128,824 [1] 150,696 [1],[2] 119,563 [1],[2]
Physician
                      
Segment Reporting Information                      
Revenues                 105,827 102,679 80,617
Gross profit                 30,614 31,455 25,858
Operating Income                 8,852 9,998 6,699
Amortization of intangible assets                 742 817 415
Assets 110,519 [1]       86,074 [1]       110,519 [1] 86,074 [1] 86,014 [1]
Corporate
                      
Segment Reporting Information                      
Operating Income                 (49,199) (47,154) (30,625)
Amortization of intangible assets                 $ 91 $ 290 $ 209
[1] As of end of the year.
[2] Life Sciences total assets as of December 31, 2012 and 2011 include assets related to the Healthcare segment, which were sold and included in discontinued operations in 2013. Historically, the Company has not reported Life Science and Healthcare segments' total assets separately as the operations were largely centralized.