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Condensed Consolidated Statements Of Income (USD $) In Thousands, except Per Share data	3 Months Ended		9 Months Ended
	Sep. 30, 2011	Sep. 30, 2010	Sep. 30, 2011	Sep. 30, 2010
Condensed Consolidated Statements Of Income [Abstract]
Net patient service revenue	$ 407,665	$ 351,058	$ 1,183,350	$ 1,033,079
Operating expenses:
Practice salaries and benefits	246,687	211,884	725,873	634,048
Practice supplies and other operating expenses	16,718	13,980	48,061	41,137
General and administrative expenses	43,010	37,499	127,510	114,762
Depreciation and amortization	6,213	6,321	18,026	16,107
Total operating expenses	312,628	269,684	919,470	806,054
Income from operations	95,037	81,374	263,880	227,025
Investment income	337	438	991	1,107
Interest expense	(1,056)	(481)	(2,955)	(2,309)
Income before income taxes	94,318	81,331	261,916	225,823
Income tax provision	36,077	20,061	102,278	76,932
Net income	$ 58,241	$ 61,270	$ 159,638	$ 148,891
Net income:
Basic	$ 1.21	$ 1.31	$ 3.36	$ 3.20
Diluted	$ 1.19	$ 1.29	$ 3.28	$ 3.14
Weighted average shares:
Basic	47,990	46,788	47,564	46,535
Diluted	48,935	47,482	48,683	47,426

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