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Selected Quarterly Financial Information (Tables) | 12 Months Ended
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Dec. 31, 2019
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, 2019 and 2018 (in thousands, except for per share data):
|  | 2019 Quarters |
|  | First |  |  | Second |  |  | Third |  |  | Fourth |
Net revenue |  | $ | 851,183 |  |  | $ | 868,309 |  |  | $ | 888,675 |  |  | $ | 905,375 |
Operating expenses: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Practice salaries and benefits |  |  | 621,539 |  |  |  | 608,962 |  |  |  | 630,309 |  |  |  | 647,968 |
Practice supplies and other operating expenses |  |  | 25,791 |  |  |  | 28,016 |  |  |  | 26,950 |  |  |  | 32,009 |
General and administrative expenses |  |  | 101,821 |  |  |  | 103,540 |  |  |  | 102,356 |  |  |  | 96,926 |
Depreciation and amortization |  |  | 20,033 |  |  |  | 19,809 |  |  |  | 19,608 |  |  |  | 19,410 |
Transformational and restructuring related expenses |  |  | 3,544 |  |  |  | 27,482 |  |  |  | 19,992 |  |  |  | 44,311 |
Goodwill impairment |  |  | — |  |  |  | — |  |  |  | 1,449,215 |  |  |  | — |
Total operating expenses |  |  | 772,728 |  |  |  | 787,809 |  |  |  | 2,248,430 |  |  |  | 840,624 |
Income (loss) from operations |  |  | 78,455 |  |  |  | 80,500 |  |  |  | (1,359,755 | ) |  |  | 64,751 |
Investment and other income |  |  | 1,647 |  |  |  | 1,222 |  |  |  | 1,373 |  |  |  | 1,429 |
Interest expense |  |  | (30,723 | ) |  |  | (31,080 | ) |  |  | (29,901 | ) |  |  | (27,677 | )
Equity in earnings of unconsolidated affiliates |  |  | 1,236 |  |  |  | 1,990 |  |  |  | 2,249 |  |  |  | 2,304 |
Total non-operating expenses |  |  | (27,840 | ) |  |  | (27,868 | ) |  |  | (26,279 | ) |  |  | (23,944 | )
Income (loss) from continuing operations before income taxes |  |  | 50,615 |  |  |  | 52,632 |  |  |  | (1,386,034 | ) |  |  | 40,807 |
Income tax (provision) benefit |  |  | (8,962 | ) |  |  | (17,116 | ) |  |  | 125,788 |  |  |  | (7,824 | )
Income (loss) from continuing operations |  |  | 41,653 |  |  |  | 35,516 |  |  |  | (1,260,246 | ) |  |  | 32,983 |
(Loss) income from discontinued operations, net of tax |  |  | (284,525 | ) |  |  | (43,761 | ) |  |  | 4,330 |  |  |  | (23,652 | )
Net (loss) income |  | $ | (242,872 | ) |  | $ | (8,245 | ) |  | $ | (1,255,916 | ) |  | $ | 9,331 |
Per common and common equivalent share data (1): |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Income (loss) from continuing operations: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  | $ | 0.48 |  |  | $ | 0.43 |  |  | $ | (15.29 | ) |  | $ | 0.40 |
Diluted |  | $ | 0.48 |  |  | $ | 0.42 |  |  | $ | (15.29 | ) |  | $ | 0.40 |
(Loss) income from discontinued operations: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  | $ | (3.31 | ) |  | $ | (0.53 | ) |  | $ | 0.05 |  |  | $ | (0.29 | )
Diluted |  | $ | (3.29 | ) |  | $ | (0.52 | ) |  | $ | 0.05 |  |  | $ | (0.29 | )
Net (loss) income: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  | $ | (2.82 | ) |  | $ | (0.10 | ) |  | $ | (15.24 | ) |  | $ | 0.11 |
Diluted |  | $ | (2.81 | ) |  | $ | (0.10 | ) |  | $ | (15.24 | ) |  | $ | 0.11 |
Weighted average common shares: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  |  | 86,073 |  |  |  | 83,234 |  |  |  | 82,441 |  |  |  | 82,592 |
Diluted |  |  | 86,545 |  |  |  | 83,689 |  |  |  | 82,441 |  |  |  | 83,288 |
(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.
|  | 2018 Quarters |
|  | First |  |  | Second |  |  | Third |  |  | Fourth |
Net revenue |  | $ | 852,628 |  |  |  | 864,987 |  |  | $ | 848,759 |  |  | $ | 888,436 |
Operating expenses: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Practice salaries and benefits |  |  | 603,955 |  |  |  | 593,047 |  |  |  | 599,326 |  |  |  | 630,048 |
Practice supplies and other operating expenses |  |  | 27,403 |  |  |  | 28,329 |  |  |  | 27,249 |  |  |  | 25,870 |
General and administrative expenses |  |  | 101,693 |  |  |  | 100,938 |  |  |  | 95,771 |  |  |  | 105,532 |
Depreciation and amortization |  |  | 19,914 |  |  |  | 20,280 |  |  |  | 22,205 |  |  |  | 21,433 |
Total operating expenses |  |  | 752,965 |  |  |  | 742,594 |  |  |  | 744,551 |  |  |  | 782,883 |
Income from operations |  |  | 99,663 |  |  |  | 122,393 |  |  |  | 104,208 |  |  |  | 105,553 |
Investment and other income |  |  | 1,474 |  |  |  | 1,225 |  |  |  | 1,531 |  |  |  | 981 |
Interest expense |  |  | (19,935 | ) |  |  | (21,618 | ) |  |  | (21,788 | ) |  |  | (25,448 | )
Equity in earnings of unconsolidated affiliates |  |  | 1,525 |  |  |  | 1,257 |  |  |  | 1,766 |  |  |  | 2,277 |
Total non-operating expenses |  |  | (16,936 | ) |  |  | (19,136 | ) |  |  | (18,491 | ) |  |  | (22,190 | )
Income from continuing operations before income taxes |  |  | 82,727 |  |  |  | 103,257 |  |  |  | 85,717 |  |  |  | 83,363 |
Income tax provision |  |  | (22,720 | ) |  |  | (28,482 | ) |  |  | (23,550 | ) |  |  | (21,701 | )
Income from continuing operations |  |  | 60,007 |  |  |  | 74,775 |  |  |  | 62,167 |  |  |  | 61,662 |
Income (loss) from discontinued operations, net of tax |  |  | 3,421 |  |  |  | 4,637 |  |  |  | 3,408 |  |  |  | (1,448 | )
Net income |  | $ | 63,428 |  |  |  | 79,412 |  |  | $ | 65,575 |  |  | $ | 60,214 |
Per common and common equivalent share data (2): |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Income from continuing operations: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  | $ | 0.65 |  |  | $ | 0.80 |  |  | $ | 0.68 |  |  | $ | 0.70 |
Diluted |  | $ | 0.64 |  |  | $ | 0.80 |  |  | $ | 0.68 |  |  | $ | 0.70 |
Income (loss) from discontinued operations: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  | $ | 0.04 |  |  | $ | 0.05 |  |  | $ | 0.04 |  |  | $ | (0.02 | )
Diluted |  | $ | 0.04 |  |  | $ | 0.05 |  |  | $ | 0.04 |  |  | $ | (0.02 | )
Net income: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Basic |  | $ | 0.68 |  |  | $ | 0.85 |  |  | $ | 0.72 |  |  | $ | 0.68 |
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 |
(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=118952077&loc=d3e1280-108306 + Details
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