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Segment Reporting (Segment Reporting Information) (Details) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended
Mar. 31, 2014
segment
Mar. 31, 2013
Segment Reporting [Abstract]    
Reportable segments (in number of segments) 4  
Revenues:    
Revenues $ 439,274 $ 379,044
Gross Profit:    
Total Gross Profit 137,588 110,111
Operating Income (Loss):    
Total Operating Income 27,282 22,855
Amortization of Intangible Assets 6,172 5,379
Apex
    
Revenues:    
Revenues 278,408 239,765
Gross Profit:    
Total Gross Profit 75,506 63,981
Operating Income (Loss):    
Total Operating Income 22,784 17,229
Amortization of Intangible Assets 4,089 4,881
Oxford
    
Revenues:    
Revenues 117,500 102,688
Gross Profit:    
Total Gross Profit 49,026 34,815
Operating Income (Loss):    
Total Operating Income 14,284 13,666
Amortization of Intangible Assets 1,370 107
Physician
    
Revenues:    
Revenues 31,791 26,302
Gross Profit:    
Total Gross Profit 8,838 7,483
Operating Income (Loss):    
Total Operating Income 1,259 2,426
Amortization of Intangible Assets 634 176
Life Sciences Europe
    
Revenues:    
Revenues 11,575 10,289
Gross Profit:    
Total Gross Profit 4,218 3,832
Operating Income (Loss):    
Total Operating Income 1,199 533
Amortization of Intangible Assets 71 160
Corporate Segment
    
Operating Income (Loss):    
Total Operating Income (12,244) (10,999)
Amortization of Intangible Assets $ 8 $ 55