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Condensed Consolidated Statements of Income - USD ($)
shares in Thousands, $ in Thousands
 3 Months Ended 6 Months Ended
Jun. 30, 2019
Jun. 30, 2018
Jun. 30, 2019
Jun. 30, 2018
Income Statement [Abstract]        
Net revenue $ 868,309 $ 864,987 $ 1,719,492 $ 1,717,615
Operating expenses:        
Practice salaries and benefits 608,962 593,047 1,230,501 1,197,004
Practice supplies and other operating expenses 28,016 28,329 53,807 55,730
General and administrative expenses 103,540 100,938 205,361 202,631
Depreciation and amortization 19,809 20,280 39,842 40,195
Transformational and restructuring related expenses 27,482 0 31,026 0
Total operating expenses 787,809 742,594 1,560,537 1,495,560
Income from operations 80,500 122,393 158,955 222,055
Investment and other income 1,222 1,225 2,869 2,699
Interest expense (31,080) (21,618) (61,803) (41,553)
Equity in earnings of unconsolidated affiliates 1,990 1,257 3,226 2,782
Total non-operating expenses (27,868) (19,136) (55,708) (36,072)
Income from continuing operations before income taxes 52,632 103,257 103,247 185,983
Income tax provision (17,116) (28,482) (26,078) (51,202)
Income from continuing operations 35,516 74,775 77,169 134,781
(Loss) income from discontinued operations, net of tax (43,761) 4,637 (328,286) 8,059
Net (loss) income $ (8,245) $ 79,412 $ (251,117) $ 142,840
Income from continuing operations:        
Basic $ 0.43 $ 0.80 $ 0.91 $ 1.45
Diluted 0.42 0.80 0.91 1.44
(Loss) income from discontinued operations:        
Basic (0.53) 0.05 (3.88) 0.09
Diluted (0.52) 0.05 (3.86) 0.09
Net (loss) income:        
Basic (0.10) 0.85 (2.97) 1.54
Diluted $ (0.10) $ 0.85 $ (2.95) $ 1.53
Weighted average common shares:        
Basic 83,234 92,987 84,623 92,922
Diluted 83,689 93,529 85,087 93,516