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Consolidated Statements of Income and Comprehensive Income (Unaudited) - USD ($)
shares in Thousands, $ in Thousands
 3 Months Ended 6 Months Ended
Jun. 30, 2024
Jun. 30, 2023
Jun. 30, 2024
Jun. 30, 2023
Income Statement [Abstract]        
Net revenue $ 504,296 $ 500,577 $ 999,397 $ 991,585
Operating expenses:        
Practice salaries and benefits 357,808 354,032 726,946 716,267
Practice supplies and other operating expenses 32,369 31,089 63,454 61,809
General and administrative expenses 56,565 58,013 116,763 117,072
Depreciation and amortization 8,791 8,945 19,099 17,898
Transformational and restructuring related expenses 13,579 0 22,059 0
Goodwill impairment 154,243 0 154,243 0
Fixed assets impairments 20,112 0 20,112 0
Intangible assets impairments 7,679 0 7,679 0
Loss on disposal of businesses 10,873 0 10,873 0
Total operating expenses 662,019 452,079 1,141,228 913,046
(Loss) income from operations (157,723) 48,498 (141,831) 78,539
Investment and other (loss) income (161) 1,189 1,852 1,823
Interest expense (10,308) (11,230) (20,907) (21,620)
Equity in earnings of unconsolidated affiliate 464 490 982 917
Total non-operating expenses (10,005) (9,551) (18,073) (18,880)
(Loss) income before income taxes (167,728) 38,947 (159,904) 59,659
Income tax benefit (provision) 14,703 (10,665) 10,914 (17,171)
Net (loss) income (153,025) 28,282 (148,990) 42,488
Unrealized holding gain (loss) on investments, net of tax of $66, $126, $86 and $353 200 (387) 260 217
Total comprehensive (loss) income $ (152,825) $ 27,895 $ (148,730) $ 42,705
Net (loss) income:        
Basic $ (1.84) $ 0.34 $ (1.79) $ 0.52
Diluted $ (1.84) $ 0.34 $ (1.79) $ 0.52
Weighted average common shares:        
Basic 83,332 82,399 83,074 82,033
Diluted 83,332 82,664 83,074 82,377