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Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 12 Months Ended
--- | --- | ---
Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017
Income Statement [Abstract] |  |  |  |  |  |  |  |  |  |  |
Net revenue | $ 905,375 | $ 888,675 | $ 868,309 | $ 851,183 | $ 888,436 | $ 848,759 | $ 864,987 | $ 852,628 | $ 3,513,542 | $ 3,454,810 | $ 3,253,391
Operating expenses: |  |  |  |  |  |  |  |  |  |  |
Practice salaries and benefits | 647,968 | 630,309 | 608,962 | 621,539 | 630,048 | 599,326 | 593,047 | 603,955 | 2,508,778 | 2,426,376 | 2,227,335
Practice supplies and other operating expenses | 32,009 | 26,950 | 28,016 | 25,791 | 25,870 | 27,249 | 28,329 | 27,403 | 112,766 | 108,851 | 106,444
General and administrative expenses | 96,926 | 102,356 | 103,540 | 101,821 | 105,532 | 95,771 | 100,938 | 101,693 | 404,643 | 403,934 | 385,864
Depreciation and amortization | 19,410 | 19,608 | 19,809 | 20,033 | 21,433 | 22,205 | 20,280 | 19,914 | 78,860 | 83,832 | 78,856
Transformational and restructuring related expenses | 44,311 | 19,992 | 27,482 | 3,544 |  |  |  |  | 95,329 | 0 | 0
Goodwill impairment |  | 1,449,215 |  |  |  |  |  |  | 1,449,215 | 0 | 0
Total operating expenses | 840,624 | 2,248,430 | 787,809 | 772,728 | 782,883 | 744,551 | 742,594 | 752,965 | 4,649,591 | 3,022,993 | 2,798,499
(Loss) income from operations | 64,751 | (1,359,755) | 80,500 | 78,455 | 105,553 | 104,208 | 122,393 | 99,663 | (1,136,049) | 431,817 | 454,892
Investment and other income | 1,429 | 1,373 | 1,222 | 1,647 | 981 | 1,531 | 1,225 | 1,474 | 5,671 | 5,211 | 4,385
Interest expense | (27,677) | (29,901) | (31,080) | (30,723) | (25,448) | (21,788) | (21,618) | (19,935) | (119,381) | (88,789) | (74,556)
Equity in earnings of unconsolidated affiliates | 2,304 | 2,249 | 1,990 | 1,236 | 2,277 | 1,766 | 1,257 | 1,525 | 7,779 | 6,825 | 952
Total non-operating expenses | (23,944) | (26,279) | (27,868) | (27,840) | (22,190) | (18,491) | (19,136) | (16,936) | (105,931) | (76,753) | (69,219)
(Loss) income from continuing operations before income taxes | 40,807 | (1,386,034) | 52,632 | 50,615 | 83,363 | 85,717 | 103,257 | 82,727 | (1,241,980) | 355,064 | 385,673
Income tax benefit (provision) | (7,824) | 125,788 | (17,116) | (8,962) | (21,701) | (23,550) | (28,482) | (22,720) | 91,886 | (96,453) | (80,231)
(Loss) income from continuing operations | 32,983 | (1,260,246) | 35,516 | 41,653 | 61,662 | 62,167 | 74,775 | 60,007 | (1,150,094) | 258,611 | 305,442
(Loss) income from discontinued operations, net of tax | (23,652) | 4,330 | (43,761) | (284,525) | (1,448) | 3,408 | 4,637 | 3,421 | (347,608) | 10,018 | 14,930
Net (loss) income | $ 9,331 | $ (1,255,916) | $ (8,245) | $ (242,872) | $ 60,214 | $ 65,575 | $ 79,412 | $ 63,428 | $ (1,497,702) | $ 268,629 | $ 320,372
(Loss) income from continuing operations: |  |  |  |  |  |  |  |  |  |  |
Basic | $ 0.40 | $ (15.29) | $ 0.43 | $ 0.48 | $ 700 | $ 680 | $ 800 | $ 650 | $ (13.78) | $ 2.84 | $ 3.31
Diluted | 0.40 | (15.29) | 0.42 | 0.48 | 700 | 680 | 800 | 640 | (13.78) | 2.82 | 3.29
Income (loss) from discontinued operations: |  |  |  |  |  |  |  |  |  |  |
Basic | (0.29) | 0.05 | (0.53) | (3.31) | (20.00) | 40.00 | 50.00 | 40.00 | (4.16) | 0.11 | 0.16
Diluted | (0.29) | 0.05 | (0.52) | (3.29) | (20.00) | 40.00 | 50.00 | 40.00 | (4.16) | 0.11 | 0.16
Net (loss) income: |  |  |  |  |  |  |  |  |  |  |
Basic | 0.11 | (15.24) | (0.10) | (2.82) | 0.68 | 0.72 | 0.85 | 0.68 | (17.94) | 2.95 | 3.47
Diluted | $ 0.11 | $ (15.24) | $ (0.10) | $ (2.81) | $ 0.68 | $ 0.72 | $ 0.85 | $ 0.68 | $ (17.94) | $ 2.93 | $ 3.45
Weighted average common shares: |  |  |  |  |  |  |  |  |  |  |
Basic | 82,592 | 82,441 | 83,234 | 86,073 | 87,810 | 90,984 | 92,987 | 92,859 | 83,495 | 91,104 | 92,431
Diluted | 83,288 | 82,441 | 83,689 | 86,545 | 88,258 | 91,359 | 93,529 | 93,505 | 83,495 | 91,606 | 92,958

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