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Condensed Consolidated Statements of Income (Unaudited) (USD $)
In Thousands, except Per Share data, unless otherwise specified
 3 Months Ended
Mar. 31, 2014
Mar. 31, 2013
Income Statement [Abstract]    
Net patient service revenue $ 566,338 $ 502,715
Operating expenses:    
Practice salaries and benefits 372,040 329,201
Practice supplies and other operating expenses 21,417 19,500
General and administrative expenses 58,414 53,318
Depreciation and amortization 10,370 9,144
Total operating expenses 462,241 411,163
Income from operations 104,097 91,552
Investment and other income 1,635 402
Interest expense (1,371) (1,189)
Income before income taxes 104,361 90,765
Income tax provision 40,701 35,398
Net income $ 63,660 $ 55,367
Net income:    
Basic $ 0.64 $ 0.56
Diluted $ 0.63 $ 0.55
Weighted average shares:    
Basic 99,076 98,618
Diluted 100,696 100,784