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Selected Quarterly Financial Information (Tables) | 12 Months Ended
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Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract] |
Summary of Company's Selected Quarterly Financial Information | The following tables set forth a summary of the Company’s selected quarterly financial information for each of the four quarters ended December 31, 2018 and 2017 (in thousands, except for per share data):
|  | 2018 Quarters |
|  | First |  |  | Second |  |  | Third |  |  | Fourth |
Net revenue |  | $ | 901,857 |  |  | $ | 915,918 |  |  | $ | 896,652 |  |  | $ | 932,696 |
Operating expenses: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Practice salaries and benefits |  |  | 631,830 |  |  |  | 620,980 |  |  |  | 625,717 |  |  |  | 657,061 |
Practice supplies and other operating expenses |  |  | 30,655 |  |  |  | 31,833 |  |  |  | 30,159 |  |  |  | 29,381 |
General and administrative expenses |  |  | 108,776 |  |  |  | 107,908 |  |  |  | 102,905 |  |  |  | 112,789 |
Depreciation and amortization |  |  | 26,163 |  |  |  | 26,518 |  |  |  | 28,709 |  |  |  | 29,891 |
Total operating expenses |  |  | 797,424 |  |  |  | 787,239 |  |  |  | 787,490 |  |  |  | 829,122 |
Income from operations |  |  | 104,433 |  |  |  | 128,679 |  |  |  | 109,162 |  |  |  | 103,574 |
Investment and other income |  |  | 1,464 |  |  |  | 1,202 |  |  |  | 1,302 |  |  |  | 967 |
Interest expense |  |  | (19,935 | ) |  |  | (21,604 | ) |  |  | (21,782 | ) |  |  | (25,448 | )
Equity in earnings of unconsolidated affiliates |  |  | 1,525 |  |  |  | 1,257 |  |  |  | 1,766 |  |  |  | 2,277 |
Total non-operating expenses |  |  | (16,946 | ) |  |  | (19,145 | ) |  |  | (18,714 | ) |  |  | (22,204 | )
Income before income taxes |  |  | 87,487 |  |  |  | 109,534 |  |  |  | 90,448 |  |  |  | 81,370 |
Income tax provision |  |  | (24,059 | ) |  |  | (30,122 | ) |  |  | (24,873 | ) |  |  | (21,156 | )
Net income |  | $ | 63,428 |  |  | $ | 79,412 |  |  | $ | 65,575 |  |  | $ | 60,214 |
Per common and common equivalent share data (1): |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  | $ | 0.68 |  |  | $ | 0.85 |  |  | $ | 0.72 |  |  | $ | 0.69 |
Diluted |  | $ | 0.68 |  |  | $ | 0.85 |  |  | $ | 0.72 |  |  | $ | 0.68 |
Weighted average common shares: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  |  | 92,859 |  |  |  | 92,987 |  |  |  | 90,984 |  |  |  | 87,810 |
Diluted |  |  | 93,505 |  |  |  | 93,529 |  |  |  | 91,359 |  |  |  | 88,258 |
(1) | Basic and diluted per share amounts are computed for each of the periods presented. Accordingly, the sum of the quarterly per share amounts may not agree with the full year amount.
|  | 2017 Quarters |
|  | First |  |  | Second |  |  | Third |  |  | Fourth |
Net revenue |  | $ | 835,597 |  |  | $ | 842,944 |  |  | $ | 868,951 |  |  | $ | 910,820 |
Operating expenses: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Practice salaries and benefits |  |  | 572,385 |  |  |  | 561,418 |  |  |  | 586,476 |  |  |  | 617,455 |
Practice supplies and other operating expenses |  |  | 27,796 |  |  |  | 30,872 |  |  |  | 29,497 |  |  |  | 32,353 |
General and administrative expenses |  |  | 103,765 |  |  |  | 103,015 |  |  |  | 101,430 |  |  |  | 108,895 |
Depreciation and amortization |  |  | 25,614 |  |  |  | 25,735 |  |  |  | 25,116 |  |  |  | 26,414 |
Total operating expenses |  |  | 729,560 |  |  |  | 721,040 |  |  |  | 742,519 |  |  |  | 785,117 |
Income from operations |  |  | 106,037 |  |  |  | 121,904 |  |  |  | 126,432 |  |  |  | 125,703 |
Investment and other income |  |  | 576 |  |  |  | 365 |  |  |  | 235 |  |  |  | 2,777 |
Interest expense |  |  | (17,752 | ) |  |  | (18,535 | ) |  |  | (18,428 | ) |  |  | (19,844 | )
Equity (loss) in earnings of unconsolidated affiliate |  |  | 797 |  |  |  | 689 |  |  |  | (240 | ) |  |  | (294 | )
Total non-operating expenses |  |  | (16,379 | ) |  |  | (17,481 | ) |  |  | (18,433 | ) |  |  | (17,361 | )
Income before income taxes |  |  | 89,658 |  |  |  | 104,423 |  |  |  | 107,999 |  |  |  | 108,342 |
Income tax (provision) benefit |  |  | (34,967 | ) |  |  | (40,725 | ) |  |  | (42,119 | ) |  |  | 27,761 |
Net income |  | $ | 54,691 |  |  | $ | 63,698 |  |  | $ | 65,880 |  |  | $ | 136,103 |
Per common and common equivalent share data (2): |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  | $ | 0.59 |  |  | $ | 0.69 |  |  | $ | 0.71 |  |  | $ | 1.47 |
Diluted |  | $ | 0.59 |  |  | $ | 0.69 |  |  | $ | 0.71 |  |  | $ | 1.46 |
Weighted average common shares: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  |  | 92,360 |  |  |  | 92,181 |  |  |  | 92,589 |  |  |  | 92,756 |
Diluted |  |  | 93,143 |  |  |  | 92,812 |  |  |  | 92,881 |  |  |  | 93,159 |
(2) | Basic and diluted per share amounts are computed for each of the periods presented. Accordingly, the sum of the quarterly per share amounts may not agree with the full year amount.

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- Definition Tabular disclosure of quarterly financial data. Includes, but is not limited to, financial information for fiscal quarters, cumulative effect of a change in accounting principle and earnings per share data. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 270 -SubTopic 10 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=109225645&loc=d3e1280-108306 + Details
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