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Consolidated Statements of Income and Comprehensive Income (Unaudited) - USD ($)
shares in Thousands, $ in Thousands
 3 Months Ended
Mar. 31, 2025
Mar. 31, 2024
Income Statement [Abstract]    
Net revenue $ 458,359 $ 495,101
Operating expenses:    
Practice salaries and benefits 337,031 369,138
Practice supplies and other operating expenses 18,686 31,085
General and administrative expenses 58,604 60,198
Depreciation and amortization 5,332 10,308
Transformational and restructuring related expenses 6,605 8,480
Total operating expenses 426,258 479,209
Income from operations 32,101 15,892
Investment and other income 4,737 2,013
Interest expense (9,154) (10,599)
Equity in earnings of unconsolidated affiliate 406 518
Total non-operating expenses (4,011) (8,068)
Income before income taxes 28,090 7,824
Income tax provision (7,353) (3,789)
Net Income 20,737 4,035
Unrealized holding gain on investments, net of tax of $[0] and $20 779 60
Total comprehensive income $ 21,516 $ 4,095
Net income:    
Basic $ 0.25 $ 0.05
Diluted $ 0.24 $ 0.05
Weighted average common shares:    
Basic 84,435 82,863
Diluted 85,430 83,275