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Consolidated Statements of Income and Comprehensive Income (Unaudited) - USD ($)
shares in Thousands, $ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Income Statement [Abstract]        
Net revenue $ 492,875 $ 511,158 $ 1,420,078 $ 1,510,555
Operating expenses:        
Practice salaries and benefits 332,326 364,888 992,859 1,091,834
Practice supplies and other operating expenses 20,200 29,449 59,500 92,903
General and administrative expenses 60,793 58,121 175,111 174,884
Depreciation and amortization 5,551 6,254 16,196 25,353
Transformational and restructuring related expenses 5,954 18,560 16,393 40,619
Goodwill impairment 0 0 0 154,243
Long-lived asset impairments 0 0 0 27,791
Loss on disposal of businesses 0 59 0 10,932
Total operating expenses 424,824 477,331 1,260,059 1,618,559
Income (loss) from operations 68,051 33,827 160,019 (108,004)
Investment and other income 5,883 1,089 14,347 2,941
Net gain on investments in divested businesses 20,906 0 20,906 0
Interest expense (8,941) (10,126) (27,225) (31,033)
Equity in earnings of unconsolidated affiliate 1,879 445 2,790 1,427
Total non-operating income (expenses) 19,727 (8,592) 10,818 (26,665)
Income (loss) before income taxes 87,778 25,235 170,837 (134,669)
Income tax (provision) benefit (16,070) (5,794) (39,132) 5,120
Net income (loss) 71,708 19,441 131,705 (129,549)
Unrealized holding gain on investments, net of tax of $101, $571, $496 and $657 309 1,745 1,517 2,005
Total comprehensive income (loss) $ 72,017 $ 21,186 $ 133,222 $ (127,544)
Net income (loss):        
Basic $ 0.85 $ 0.23 $ 1.56 $ (1.56)
Diluted $ 0.84 $ 0.23 $ 1.54 $ (1.56)
Weighted average common shares:        
Basic 84,609 83,891 84,649 83,223
Diluted 85,613 84,523 85,559 83,223