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Condensed Consolidated Statements Of Income (USD $)
In Thousands, except Per Share data, unless otherwise specified
 3 Months Ended
Mar. 31, 2012
Mar. 31, 2011
Condensed Consolidated Statements Of Income [Abstract]    
Net patient service revenue $ 422,616 $ 382,283
Operating expenses:    
Practice salaries and benefits 272,261 243,894
Practice supplies and other operating expenses 16,985 15,090
General and administrative expenses 46,869 41,798
Depreciation and amortization 7,113 5,781
Total operating expenses 343,228 306,563
Income from operations 79,388 75,720
Investment income 428 325
Interest expense (554) (911)
Income before income taxes 79,262 75,134
Income tax provision 30,912 29,678
Net income $ 48,350 $ 45,456
Net income:    
Basic $ 1.00 $ 0.96
Diluted $ 0.98 $ 0.94
Weighted average shares:    
Basic 48,269 47,149
Diluted 49,399 48,361