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Accrued Professional Liabilities - Additional Information (Detail) - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014 | Dec. 31, 2013
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Payables and Accruals [Abstract] |  |  |  |
Total accrued professional liability | $ 202,052 | $ 202,527 | $ 168,369 | $ 158,691
Accrued professional liability incurred but loss reserves not reported for claims | 128,100 | 135,100 |  |
Accrued professional liability incurred and loss reserves reported for claims | $ 74,000 | $ 67,400 |  |

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- Definition Accrued professional liability. + References No definition available. + Details
Name: | md_AccruedProfessionalLiability
Namespace Prefix: | md_
Data Type: | xbrli:monetaryItemType
Balance Type: | credit
Period Type: | instant

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- Definition Amount of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability) at the end of the accounting period. + 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
Name: | us-gaap_MalpracticeLossContingencyAccrualUndiscounted
Namespace Prefix: | us-gaap_
Data Type: | xbrli:monetaryItemType
Balance Type: | credit
Period Type: | instant

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- References No definition available. + Details
Name: | us-gaap_PayablesAndAccrualsAbstract
Namespace Prefix: | us-gaap_
Data Type: | xbrli:stringItemType
Balance Type: | na
Period Type: | duration

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- Definition Carrying amount of accrued known and estimated losses incurred as of the balance sheet date for which no insurance coverage exists, and for which a claim has been made or is probable of being asserted, typically arising from workmen's compensation-type of incidents and personal injury to nonemployees from accidents on the entity's property that are expected to be paid within one year (or the normal operating cycle, if longer). + References No definition available. + Details
Name: | us-gaap_SelfInsuranceReserveCurrent
Namespace Prefix: | us-gaap_
Data Type: | xbrli:monetaryItemType
Balance Type: | credit
Period Type: | instant