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Condensed Consolidated Statements of Income (USD $)
In Thousands, except Per Share data
 3 Months Ended 6 Months Ended
Jun. 30, 2011
Jun. 30, 2010
Jun. 30, 2011
Jun. 30, 2010
Condensed Consolidated Statements of Income        
Net patient service revenue $ 393,402 $ 349,094 $ 775,685 $ 682,021
Operating expenses:        
Practice salaries and benefits 235,292 208,762 479,186 422,164
Practice supplies and other operating expenses 16,253 14,062 31,343 27,157
General and administrative expenses 42,702 39,164 84,500 77,263
Depreciation and amortization 6,032 5,006 11,813 9,786
Total operating expenses 300,279 266,994 606,842 536,370
Income from operations 93,123 82,100 168,843 145,651
Investment income 329 265 654 669
Interest expense (988) (1,118) (1,899) (1,828)
Income before income taxes 92,464 81,247 167,598 144,492
Income tax provision 36,523 31,889 66,201 56,871
Net income $ 55,941 $ 49,358 $ 101,397 $ 87,621
Net income:        
Basic $ 1.18 $ 1.06 $ 2.14 $ 1.89
Diluted $ 1.15 $ 1.04 $ 2.09 $ 1.85
Weighted average shares:        
Basic 47,531 46,516 47,341 46,409
Diluted 48,730 47,528 48,547 47,398