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Accrued Professional Liabilities - Schedule of Accrued Professional Liability (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Payables and Accruals [Abstract]      
Balance at beginning of year $ 151,397 $ 128,799 $ 138,643
Liabilities recognized, offset by insurance Receivable 3,922 10,354  
Provision (adjustment) for losses related to Current year 45,674 42,733 37,203
Provision (adjustment) for losses related to Prior years (1,551) (7,766) (7,087)
Total provision for losses 44,123 34,967 30,116
Claim payments related to Current year (59) (33) (50)
Claim payments related to Prior years (24,580) (22,690) (39,910)
Total payments (24,639) (22,723) (39,960)
Balance at end of year $ 174,803 $ 151,397 $ 128,799