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Condensed Consolidated Statements Of Income (USD $)
In Thousands, except Per Share data, unless otherwise specified
 3 Months Ended 9 Months Ended
Sep. 30, 2012
Sep. 30, 2011
Sep. 30, 2012
Sep. 30, 2011
Net patient service revenue $ 473,134 $ 407,665 $ 1,345,280 $ 1,183,350
Operating expenses:        
Practice salaries and benefits 292,030 246,687 840,242 725,873
Practice supplies and other operating expenses 17,606 16,718 52,547 48,061
General and administrative expenses 48,200 43,010 143,269 127,510
Depreciation and amortization 7,925 6,213 22,725 18,026
Total operating expenses 365,761 312,628 1,058,783 919,470
Income from operations 107,373 95,037 286,497 263,880
Investment income 422 337 1,215 991
Interest expense (624) (1,056) (2,026) (2,955)
Income before income taxes 107,171 94,318 285,686 261,916
Income tax provision 41,261 36,077 110,882 102,278
Net income $ 65,910 $ 58,241 $ 174,804 $ 159,638
Net income:        
Basic $ 1.35 $ 1.21 $ 3.60 $ 3.36
Diluted $ 1.32 $ 1.19 $ 3.53 $ 3.28
Weighted average shares:        
Basic 48,938 47,990 48,569 47,564
Diluted 49,809 48,935 49,570 48,683