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Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Sep. 30, 2019
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Goodwill And Other Intangible Assets [Line Items]        
Goodwill   $ 2,710,292 $ 4,061,439  
Non cash impairment charge of goodwill $ 1,449,215 1,449,215 0 $ 0
Goodwill recognition of deferred tax asset   147,200    
Goodwill incremental impairment charges   147,200    
Accumulated Non cash impairment charge of goodwill   1,450,000    
Intangible assets related to acquisitions   14,000    
Amortization expense for intangible assets   $ 48,900 $ 54,500 $ 52,500
Physician And Hospital Agreements [Member]        
Goodwill And Other Intangible Assets [Line Items]        
Weighted average amortization period   8 years    
Anaesthesiology Reporting Unit [Member]        
Goodwill And Other Intangible Assets [Line Items]        
Non cash impairment charge of goodwill $ 1,300,000