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Segment Reporting (Tables)
9 Months Ended
Sep. 30, 2014
Segment Reporting [Abstract]  
Schedule of Segment Reporting Information, by Segment
The following tables present revenues, gross profit, operating income and amortization by reportable segment (in thousands):
 
Three Months Ended September 30, 2014
 
Apex
 
Oxford
 
Physician
 
Life Sciences Europe
 
Corporate
 
Total
Revenues
$
306,027

 
$
125,944

 
$
34,948

 
$
10,905

 
$

 
$
477,824

Gross profit
87,323

 
54,267

 
10,344

 
3,672

 

 
155,606

Operating income
33,735

 
18,323

 
2,714

 
490

 
(14,379
)
 
40,883

Amortization
4,089

 
1,375

 
486

 
68

 

 
6,018


 
Three Months Ended September 30, 2013
 
Apex
 
Oxford
 
Physician
 
Life Sciences Europe
 
Corporate
 
Total
Revenues
$
276,849

 
$
107,413

 
$
26,223

 
$
11,006

 
$

 
$
421,491

Gross profit
78,854

 
36,825

 
7,382

 
4,149

 

 
127,210

Operating income
28,849

 
15,911

 
1,783

 
1,774

 
(12,635
)
 
35,682

Amortization
4,881

 
96

 
111

 
103

 
8

 
5,199


 
Nine Months Ended September 30, 2014
 
Apex
 
Oxford
 
Physician
 
Life Sciences Europe
 
Corporate
 
Total
Revenues
$
882,328

 
$
369,448

 
$
100,396

 
$
33,544

 
$

 
$
1,385,716

Gross profit
247,506

 
156,904

 
29,480

 
12,031

 

 
445,921

Operating income
88,227

 
50,435

 
6,428

 
2,717

 
(40,994
)
 
106,813

Amortization
12,267

 
4,107

 
1,754

 
210

 
8

 
18,346


 
Nine Months Ended September 30, 2013
 
Apex
 
Oxford
 
Physician
 
Life Sciences Europe
 
Corporate
 
Total
Revenues
$
778,961

 
$
319,254

 
$
78,991

 
$
31,193

 
$

 
$
1,208,399

Gross profit
215,747

 
108,762

 
22,505

 
11,639

 

 
358,653

Operating income
70,715

 
45,521

 
6,422

 
2,755

 
(35,101
)
 
90,312

Amortization
14,643

 
299

 
463

 
365

 
83

 
15,853


Schedule of Revenue by Geographical Areas
The Company operates internationally, with operations mainly in the United States, Europe, Canada, Australia and New Zealand. The following table presents domestic and foreign revenues (in thousands):
 
Three Months Ended
 
Nine Months Ended
 
September 30,
 
September 30,
 
2014
 
2013
 
2014
 
2013
Revenues:
 
 
 
 
 
 
 
Domestic
$
456,601

 
$
401,137

 
$
1,323,561

 
$
1,148,529

Foreign
21,223

 
20,354

 
62,155

 
59,870

 
$
477,824

 
$
421,491

 
$
1,385,716

 
$
1,208,399