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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
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.