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Segment Reporting (Segment Reporting Information) (Details) (USD $)
In Thousands, unless otherwise specified
 3 Months Ended 9 Months Ended
Sep. 30, 2014
Sep. 30, 2013
Sep. 30, 2014
segment
Sep. 30, 2013
Segment Reporting [Abstract]        
Reportable segments (in number of segments)     4  
Revenues:        
Revenues $ 477,824 $ 421,491 $ 1,385,716 $ 1,208,399
Gross Profit:        
Total Gross Profit 155,606 127,210 445,921 358,653
Operating Income (Loss):        
Total Operating Income 40,883 35,682 106,813 90,312
Amortization of Intangible Assets 6,018 5,199 18,346 15,853
Apex
        
Revenues:        
Revenues 306,027 276,849 882,328 778,961
Gross Profit:        
Total Gross Profit 87,323 78,854 247,506 215,747
Operating Income (Loss):        
Total Operating Income 33,735 28,849 88,227 70,715
Amortization of Intangible Assets 4,089 4,881 12,267 14,643
Oxford
        
Revenues:        
Revenues 125,944 107,413 369,448 319,254
Gross Profit:        
Total Gross Profit 54,267 36,825 156,904 108,762
Operating Income (Loss):        
Total Operating Income 18,323 15,911 50,435 45,521
Amortization of Intangible Assets 1,375 96 4,107 299
Physician
        
Revenues:        
Revenues 34,948 26,223 100,396 78,991
Gross Profit:        
Total Gross Profit 10,344 7,382 29,480 22,505
Operating Income (Loss):        
Total Operating Income 2,714 1,783 6,428 6,422
Amortization of Intangible Assets 486 111 1,754 463
Life Sciences Europe
        
Revenues:        
Revenues 10,905 11,006 33,544 31,193
Gross Profit:        
Total Gross Profit 3,672 4,149 12,031 11,639
Operating Income (Loss):        
Total Operating Income 490 1,774 2,717 2,755
Amortization of Intangible Assets 68 103 210 365
Corporate Segment
        
Operating Income (Loss):        
Total Operating Income (14,379) (12,635) (40,994) (35,101)
Amortization of Intangible Assets $ 0 $ 8 $ 8 $ 83