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Selected Quarterly Financial Information (Unaudited) - Summary of Company's Selected Quarterly Financial Information (Detail) (USD $) In Thousands, except Per Share data, unless otherwise specified | 3 Months Ended | 12 Months Ended
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Dec. 31, 2012 | Sep. 30, 2012 | Jun. 30, 2012 | Mar. 31, 2012 | Dec. 31, 2011 | Sep. 30, 2011 | Jun. 30, 2011 | Mar. 31, 2011 | Dec. 31, 2012 | Dec. 31, 2011 | Dec. 31, 2010
Schedule Of Quarterly Financial Summary [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net patient service revenue | $ 471,332 |  | $ 473,134 |  | $ 449,530 |  | $ 422,616 |  | $ 404,898 |  | $ 407,665 |  | $ 393,402 |  | $ 382,283 |  | $ 1,816,612 | $ 1,588,248 | $ 1,401,559
Practice salaries and benefits | 290,671 |  | 292,030 |  | 275,951 |  | 272,261 |  | 244,523 |  | 246,687 |  | 235,292 |  | 243,894 |  | 1,130,913 | 970,396 | 854,920
Practice supplies and other operating expenses | 19,276 |  | 17,606 |  | 17,956 |  | 16,985 |  | 18,754 |  | 16,718 |  | 16,253 |  | 15,090 |  | 71,823 | 66,815 | 57,511
General and administrative expenses | 50,271 |  | 48,200 |  | 48,200 |  | 46,869 |  | 42,846 |  | 43,010 |  | 42,702 |  | 41,798 |  | 193,540 | 170,356 | 154,267
Depreciation and amortization | 8,091 |  | 7,925 |  | 7,687 |  | 7,113 |  | 7,266 |  | 6,213 |  | 6,032 |  | 5,781 |  | 30,816 | 25,292 | 21,950
Total operating expenses | 368,309 |  | 365,761 |  | 349,794 |  | 343,228 |  | 313,389 |  | 312,628 |  | 300,279 |  | 306,563 |  | 1,427,092 | 1,232,859 | 1,088,648
Income from operations | 103,023 |  | 107,373 |  | 99,736 |  | 79,388 |  | 91,509 |  | 95,037 |  | 93,123 |  | 75,720 |  | 389,520 | 355,389 | 312,911
Investment income | 681 |  | 422 |  | 365 |  | 428 |  | 504 |  | 337 |  | 329 |  | 325 |  | 1,896 | 1,495 | 1,434
Interest expense | (1,219) |  | (624) |  | (848) |  | (554) |  | (684) |  | (1,056) |  | (988) |  | (911) |  | (3,245) | (3,639) | (3,193)
Income before income taxes | 102,485 |  | 107,171 |  | 99,253 |  | 79,262 |  | 91,329 |  | 94,318 |  | 92,464 |  | 75,134 |  | 388,171 | 353,245 | 311,152
Income tax provision | 36,382 |  | 41,261 |  | 38,709 |  | 30,912 |  | 32,970 |  | 36,077 |  | 36,523 |  | 29,678 |  | 147,264 | 135,248 | 108,461
Net income | $ 66,103 |  | $ 65,910 |  | $ 60,544 |  | $ 48,350 |  | $ 58,359 |  | $ 58,241 |  | $ 55,941 |  | $ 45,456 |  | $ 240,907 | $ 217,997 | $ 202,691
Net income, Basic | $ 1.35 | [1] | $ 1.35 | [1] | $ 1.25 | [1] | $ 1.00 | [1] | $ 1.21 | [1] | $ 1.21 | [1] | $ 1.18 | [1] | $ 0.96 | [1] | $ 4.95 | $ 4.57 | $ 4.35
Net income, Diluted | $ 1.32 | [1] | $ 1.32 | [1] | $ 1.22 | [1] | $ 0.98 | [1] | $ 1.19 | [1] | $ 1.19 | [1] | $ 1.15 | [1] | $ 0.94 | [1] | $ 4.85 | $ 4.47 | $ 4.26
Weighted average shares, Basic | 49,113 | [1] | 48,938 | [1] | 48,543 | [1] | 48,269 | [1] | 48,126 | [1] | 47,990 | [1] | 47,531 | [1] | 47,149 | [1] | 48,693 | 47,706 | 46,630
Weighted average shares, Diluted | 50,106 | [1] | 49,809 | [1] | 49,545 | [1] | 49,399 | [1] | 49,132 | [1] | 48,935 | [1] | 48,730 | [1] | 48,361 | [1] | 49,691 | 48,796 | 47,570
[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.

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