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Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail) (USD $) In Thousands, unless otherwise specified | Dec. 31, 2014 | Dec. 31, 2013
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Components Of Deferred Income Tax Assets And Liabilities [Line Items] |  |
Allowance for uncollectible accounts | $ 48,178 us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts | $ 42,425 us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts
Reserves and accruals | 62,708 us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves | 52,519 us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves
Stock-based compensation | 14,354 us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost | 16,457 us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost
Net operating loss carryforward | 10,933 us-gaap_DeferredTaxAssetsOperatingLossCarryforwards | 6,385 us-gaap_DeferredTaxAssetsOperatingLossCarryforwards
Property and equipment | 1,524 us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment | 1,310 us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment
Other | 1,461 us-gaap_DeferredTaxAssetsOther | 446 us-gaap_DeferredTaxAssetsOther
Total deferred tax assets | 139,158 us-gaap_DeferredTaxAssetsNet | 119,542 us-gaap_DeferredTaxAssetsNet
Amortization | (214,968)md_DeferredTaxLiabilitiesAmortization | (162,399)md_DeferredTaxLiabilitiesAmortization
Accrual to cash adjustment | (38,524)us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals | (37,818)us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals
Other | (192)us-gaap_DeferredTaxLiabilitiesOther |
Total deferred tax liabilities | (253,684)us-gaap_DeferredIncomeTaxLiabilities | (200,217)us-gaap_DeferredIncomeTaxLiabilities
Net deferred tax (liability) asset | (114,526)us-gaap_DeferredTaxLiabilities | (80,675)us-gaap_DeferredTaxLiabilities
Total deferred tax assets | (139,158)us-gaap_DeferredTaxAssetsNet | (119,542)us-gaap_DeferredTaxAssetsNet
Amortization | (214,968)md_DeferredTaxLiabilitiesAmortization | (162,399)md_DeferredTaxLiabilitiesAmortization
Accrual to cash adjustment | (38,524)us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals | (37,818)us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals
Other | (192)us-gaap_DeferredTaxLiabilitiesOther |
Total deferred tax liabilities | (253,684)us-gaap_DeferredIncomeTaxLiabilities | (200,217)us-gaap_DeferredIncomeTaxLiabilities
Net deferred tax (liability) asset | (114,526)us-gaap_DeferredTaxLiabilities | (80,675)us-gaap_DeferredTaxLiabilities
Total deferred tax liabilities | 253,684 us-gaap_DeferredIncomeTaxLiabilities | 200,217 us-gaap_DeferredIncomeTaxLiabilities
Net deferred tax (liability) asset | (114,526)us-gaap_DeferredTaxLiabilities | (80,675)us-gaap_DeferredTaxLiabilities
Current [Member] |  |
Components Of Deferred Income Tax Assets And Liabilities [Line Items] |  |
Allowance for uncollectible accounts | 48,178 us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | 42,425 us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Reserves and accruals | 26,066 us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | 18,341 us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Stock-based compensation | 8,346 us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | 3,628 us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Net operating loss carryforward | 1,504 us-gaap_DeferredTaxAssetsOperatingLossCarryforwards / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | 3,744 us-gaap_DeferredTaxAssetsOperatingLossCarryforwards / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Other | 583 us-gaap_DeferredTaxAssetsOther / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | 446 us-gaap_DeferredTaxAssetsOther / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Total deferred tax assets | 84,677 us-gaap_DeferredTaxAssetsNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | 68,584 us-gaap_DeferredTaxAssetsNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Accrual to cash adjustment | (38,524)us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | (37,818)us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Other | (192)us-gaap_DeferredTaxLiabilitiesOther / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember |
Total deferred tax liabilities | (38,716)us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | (37,818)us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Net deferred tax (liability) asset | 45,961 us-gaap_DeferredTaxAssetsLiabilitiesNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | 30,766 us-gaap_DeferredTaxAssetsLiabilitiesNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Total deferred tax assets | (84,677)us-gaap_DeferredTaxAssetsNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | (68,584)us-gaap_DeferredTaxAssetsNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Accrual to cash adjustment | (38,524)us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | (37,818)us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Other | (192)us-gaap_DeferredTaxLiabilitiesOther / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember |
Total deferred tax liabilities | (38,716)us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | (37,818)us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Net deferred tax (liability) asset | 45,961 us-gaap_DeferredTaxAssetsLiabilitiesNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | 30,766 us-gaap_DeferredTaxAssetsLiabilitiesNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Total deferred tax liabilities | 38,716 us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | 37,818 us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Net deferred tax (liability) asset | 45,961 us-gaap_DeferredTaxAssetsLiabilitiesNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember | 30,766 us-gaap_DeferredTaxAssetsLiabilitiesNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_CurrentMember
Non-Current [Member] |  |
Components Of Deferred Income Tax Assets And Liabilities [Line Items] |  |
Reserves and accruals | 36,642 us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | 34,178 us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Stock-based compensation | 6,008 us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | 12,829 us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Net operating loss carryforward | 9,429 us-gaap_DeferredTaxAssetsOperatingLossCarryforwards / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | 2,641 us-gaap_DeferredTaxAssetsOperatingLossCarryforwards / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Property and equipment | 1,524 us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | 1,310 us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Other | 878 us-gaap_DeferredTaxAssetsOther / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember |
Total deferred tax assets | 54,481 us-gaap_DeferredTaxAssetsNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | 50,958 us-gaap_DeferredTaxAssetsNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Amortization | (214,968)md_DeferredTaxLiabilitiesAmortization / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | (162,399)md_DeferredTaxLiabilitiesAmortization / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Total deferred tax liabilities | (214,968)us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | (162,399)us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Net deferred tax (liability) asset | (160,487)us-gaap_DeferredTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | (111,441)us-gaap_DeferredTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Total deferred tax assets | (54,481)us-gaap_DeferredTaxAssetsNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | (50,958)us-gaap_DeferredTaxAssetsNet / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Amortization | (214,968)md_DeferredTaxLiabilitiesAmortization / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | (162,399)md_DeferredTaxLiabilitiesAmortization / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Total deferred tax liabilities | (214,968)us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | (162,399)us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Net deferred tax (liability) asset | (160,487)us-gaap_DeferredTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | (111,441)us-gaap_DeferredTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Total deferred tax liabilities | 214,968 us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | 162,399 us-gaap_DeferredIncomeTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember
Net deferred tax (liability) asset | $ (160,487)us-gaap_DeferredTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember | $ (111,441)us-gaap_DeferredTaxLiabilities / us-gaap_ValuationAllowanceByDeferredTaxAssetAxis = md_NonCurrentMember

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- Definition Deferred tax liabilities amortization. + References No definition available. + Details
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- Definition Amount of deferred tax liability attributable to taxable temporary differences. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Deferred Tax Liability -URI http://asc.fasb.org/extlink&oid=6510232 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32537-109319 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 03 -Paragraph 15 -Subparagraph b(2) -Article 7 + Details
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- Definition Amount after allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences and carryforwards, net of deferred tax liability attributable to taxable temporary differences. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32537-109319 + Details
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- Definition Amount after allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences and carryforwards. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (b),(c) -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32537-109319 + Details
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- Definition Amount before allocation of valuation allowances of deferred tax asset attributable to deductible operating loss carryforwards. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 6 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32621-109319 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32632-109319 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 25 -Paragraph 20 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=29652012&loc=d3e28680-109314 + Details
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- Definition Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences not separately disclosed. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 6 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32621-109319 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 25 -Paragraph 20 -URI http://asc.fasb.org/extlink&oid=29652012&loc=d3e28680-109314 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32632-109319 + Details
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- Definition Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences from property, plant, and equipment. + References No definition available. + Details
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- Definition Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences from share-based compensation. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 6 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32621-109319 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32632-109319 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 25 -Paragraph 20 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=29652012&loc=d3e28680-109314 + Details
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- Definition Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences from the allowance for doubtful accounts. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 6 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32621-109319 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32632-109319 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 25 -Paragraph 20 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=29652012&loc=d3e28680-109314 + Details
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- Definition Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences from other reserves not separately disclosed. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 6 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32621-109319 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32632-109319 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 25 -Paragraph 20 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=29652012&loc=d3e28680-109314 + Details
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- Definition Amount of deferred tax liability attributable to taxable temporary differences net of deferred tax asset attributable to deductible temporary differences and carryforwards after valuation allowances. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32537-109319 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 45 -Paragraph 6 -URI http://asc.fasb.org/extlink&oid=37586315&loc=d3e31931-109318 + Details
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- Definition Amount of deferred tax liability attributable to taxable temporary differences not separately disclosed. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 6 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32621-109319 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 25 -Paragraph 20 -URI http://asc.fasb.org/extlink&oid=29652012&loc=d3e28680-109314 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32632-109319 + Details
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