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Accounts Payable and Accrued Expenses - Schedule of Accounts Payable and Accrued Expenses (Detail) - USD ($) $ in Thousands | Dec. 31, 2017 | Dec. 31, 2016
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Payables and Accruals [Abstract] |  |
Accounts payable | $ 34,632 | $ 28,474
Accrued salaries and bonuses | 225,429 | 220,635
Accrued payroll taxes and benefits | 75,672 | 67,830
Accrued professional liabilities | 37,912 | 28,972
Accrued contingent consideration | 6,259 | 6,566
Accrued interest | 4,495 | 4,511
Other accrued expenses | 53,618 | 50,950
Accounts payable and accrued expenses, total | $ 438,017 | $ 407,938

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