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Accounts Payable and Accrued Expenses - Schedule of Accounts Payable and Accrued Expenses (Detail) (USD $) In Thousands, unless otherwise specified | Dec. 31, 2014 | Dec. 31, 2013
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Payables and Accruals [Abstract] |  |
Accounts payable | $ 32,783 us-gaap_AccountsPayableCurrent | $ 18,605 us-gaap_AccountsPayableCurrent
Accrued salaries and bonuses | 231,390 us-gaap_AccruedSalariesCurrent | 189,439 us-gaap_AccruedSalariesCurrent
Accrued payroll taxes and benefits | 49,858 us-gaap_EmployeeRelatedLiabilitiesCurrent | 43,403 us-gaap_EmployeeRelatedLiabilitiesCurrent
Accrued professional liability | 19,718 us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent | 19,324 us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent
Accrued contingent consideration | 17,010 md_AccruedContingentConsiderationLiability | 19,833 md_AccruedContingentConsiderationLiability
Other accrued expenses | 29,899 us-gaap_OtherAccruedLiabilitiesCurrent | 18,150 us-gaap_OtherAccruedLiabilitiesCurrent
Accounts payable and accrued expenses, total | $ 380,658 us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent | $ 308,754 us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent

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- Definition Sum of the carrying values as of the balance sheet date of obligations incurred through that date and due within one year (or the operating cycle, if longer), including liabilities incurred (and for which invoices have typically been received) and payable to vendors for goods and services received, taxes, interest, rent and utilities, accrued salaries and bonuses, payroll taxes and fringe benefits. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02.19,20) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 02 -Paragraph 20 -Article 5 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 02 -Paragraph 19 -Article 5 + Details
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- Definition Carrying value as of the balance sheet date of liabilities incurred (and for which invoices have typically been received) and payable to vendors for goods and services received that are used in an entity's business. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer). + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 02 -Paragraph 19 -Subparagraph a -Article 5 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02.19(a)) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 + Details
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- Definition Total of the carrying values as of the balance sheet date of obligations incurred through that date and payable for obligations related to services received from employees, such as accrued salaries and bonuses, payroll taxes and fringe benefits. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer). + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 02 -Paragraph 20 -Article 5 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02.20) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 + Details
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- Definition Amount of the current portion of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability). + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=25496072&loc=d3e14326-108349 + Details
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