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Selected Quarterly Financial Information (Summary Of Company's Selected Quarterly Financial Information) (Details) (USD $)
In Thousands, except Per Share data, unless otherwise specified
 3 Months Ended 12 Months Ended
Dec. 31, 2011
Sep. 30, 2011
Jun. 30, 2011
Mar. 31, 2011
Dec. 31, 2010
Sep. 30, 2010
Jun. 30, 2010
Mar. 31, 2010
Dec. 31, 2011
Dec. 31, 2010
Dec. 31, 2009
Selected Quarterly Financial Information [Abstract]                      
Net patient service revenue $ 404,898 $ 407,665 $ 393,402 $ 382,283 $ 368,480 $ 351,058 $ 349,094 $ 332,927 $ 1,588,248 $ 1,401,559 $ 1,288,264
Practice salaries and benefits 244,523 246,687 235,292 243,894 220,872 211,884 208,762 213,402 970,396 854,920 783,493
Practice supplies and other operating expenses 18,754 16,718 16,253 15,090 16,374 13,980 14,062 13,095 66,815 57,511 52,232
General and administrative expenses 42,846 43,010 42,702 41,798 39,505 37,499 39,164 38,099 170,356 154,267 147,162
Depreciation and amortization 7,266 6,213 6,032 5,781 5,843 6,321 5,006 4,780 25,292 21,950 16,448
Total operating expenses 313,389 312,628 300,279 306,563 282,594 269,684 266,994 269,376 1,232,859 1,088,648 999,335
Income from operations 91,509 95,037 93,123 75,720 85,886 81,374 82,100 63,551 355,389 312,911 288,929
Investment income 504 337 329 325 327 438 265 404 1,495 1,434 1,682
Interest expense (684) (1,056) (988) (911) (884) (481) (1,118) (710) (3,639) (3,193) (2,911)
Income before income taxes 91,329 94,318 92,464 75,134 85,329 81,331 81,247 63,245 353,245 311,152 287,700
Income tax provision 32,970 36,077 36,523 29,678 31,529 20,061 31,889 24,982 135,248 108,461 111,896
Net income $ 58,359 $ 58,241 $ 55,941 $ 45,456 $ 53,800 $ 61,270 $ 49,358 $ 38,263 $ 217,997 $ 202,691 $ 175,804
Net income, Basic $ 1.21 [1] $ 1.21 [1] $ 1.18 [1] $ 0.96 [1] $ 1.15 [1] $ 1.31 [1] $ 1.06 [1] $ 0.83 [1] $ 4.57 $ 4.35 $ 3.86
Net income, Diluted $ 1.19 [1] $ 1.19 [1] $ 1.15 [1] $ 0.94 [1] $ 1.12 [1] $ 1.29 [1] $ 1.04 [1] $ 0.81 [1] $ 4.47 $ 4.26 $ 3.78
Weighted average shares, Basic 48,126 [1] 47,990 [1] 47,531 [1] 47,149 [1] 46,914 [1] 46,788 [1] 46,516 [1] 46,300 [1] 47,706 46,630 45,573
Weighted average shares, Diluted 49,132 [1] 48,935 [1] 48,730 [1] 48,361 [1] 47,998 [1] 47,482 [1] 47,528 [1] 47,267 [1] 48,796 47,570 46,471
[1] Basic and diluted per share amounts are computed for each of the periods presented. Accordingly, the sum of the quarterly per share amounts may not agree with the full year amount.