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Discontinued Operations (Details) - USD ($)
$ in Thousands
 12 Months Ended
Feb. 01, 2015
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]        
Proceeds from Divestiture of Businesses, Net of Cash Divested   $ 0 $ 6,000 $ 115,440
Discontinued Operation, Gain (Loss) on Disposal of Discontinued Operation, Net of Tax   0 0 25,703
Cash Provided by (Used in) Operating Activities, Discontinued Operations       (1,778)
Disposal Group, Including Discontinued Operation, Revenue       12,068
Disposal Group Including Discontinued Operations Cost of Services       8,653
Disposal Group, Including Discontinued Operation, Gross Profit (Loss)       3,415
Disposal Group, Including Discontinued Operation, General and Administrative Expense       2,385
Disposal Group Including Discontinued Operations Amortization of Intangible Assets       155
Discontinued Operation, Income (Loss) from Discontinued Operation, before Income Tax       875
Discontinued Operation, Tax Effect of Discontinued Operation       350
Income (Loss) from Discontinued Operations, Net of Tax, Attributable to Parent   $ (199) $ 5 $ 525
Physician Segment [Member]        
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]        
Proceeds from Divestiture of Businesses $ 123,000      
Discontinued Operation, Gain (Loss) on Disposal of Discontinued Operation, Net of Tax 25,700      
Discontinued Operation, Tax Effect of Gain (Loss) from Disposal of Discontinued Operation $ 14,400