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Stock Option Plans and Share-Based Compensation - Narrative (Details) (USD $)	3 Months Ended		6 Months Ended		3 Months Ended	6 Months Ended	3 Months Ended		6 Months Ended			0 Months Ended	12 Months Ended	0 Months Ended	3 Months Ended	6 Months Ended	3 Months Ended	6 Months Ended		6 Months Ended	3 Months Ended
	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014 Restricted Stock	Jun. 30, 2014 Restricted Stock	Jun. 30, 2014 Performance-Based Restricted Stock Units	Jun. 30, 2013 Performance-Based Restricted Stock Units	Jun. 30, 2014 Performance-Based Restricted Stock Units	Jun. 30, 2013 Performance-Based Restricted Stock Units	Dec. 31, 2012 Performance-Based Restricted Stock Units	Jan. 22, 2013 Performance-Based Restricted Stock Units 2012 PSU	Dec. 31, 2012 Performance-Based Restricted Stock Units 2012 PSU	Mar. 20, 2014 Performance-Based Restricted Stock Units 2013 PSU	Mar. 31, 2014 Performance-Based Restricted Stock Units 2013 PSU	Jun. 30, 2014 Performance-Based Restricted Stock Units 2013 PSU	Jun. 30, 2014 Employee Stock [Member]	Jun. 30, 2014 Employee Stock [Member]	Jun. 30, 2014 2009 Equity Incentive Plan	Jun. 30, 2014 2009 Equity Incentive Plan Stock Options	Mar. 31, 2014 Below the 75th percentile ranking [Member] Minimum [Member] PSU program year one [Member] Performance-Based Restricted Stock Units	Mar. 31, 2014 Below the 75th percentile ranking [Member] Maximum [Member] PSU program year one [Member] Performance-Based Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
PSU percentage eligible for time-based vesting																					110.00%	119.00%
Capital shares reserved for future issuance																	846,891	846,891	2,361,284
Compensation cost not yet recognized																				$ 5,900,000
Compensation cost not yet recognized, period for recognition					2 years 6 months				1 year 6 months 6 days											2 years 8 months 12 days
Options, exercises in period, intrinsic value	5,300,000		7,900,000
Compensation costs not yet recognized					6,300,000	6,300,000	2,300,000		2,300,000
Awards granted						39,000			135,000				125,000		132,500	132,500
Number of shares eligible for vesting											62,500
PSU shares eligible for vesting based on actual shareholder return												62,500		137,500
Allocated share-based compensation expense	$ 2,720,000	$ 2,687,000	$ 5,449,000	$ 5,613,000			$ 500,000	$ 400,000	$ 1,000,000	$ 800,000
Percentile ranking of 2012 shareholder return												35.30%
PSU percentage eligible for vesting based on actual return												50.00%		100.00%
First year share vesting rate												25.00%		25.00%
Percentile ranking of 2013 shareholder return														63.94%
Shares issued in period																	0	254,009

X

- Definition

Percentile ranking of 2012 shareholder return = the actual percentile ranking for our entity among the health care stock index companies for calendar 2012 total shareholder return

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Percentile Ranking of 2013 Shareholder Return = the actual percentile ranking for our entity among the health care stock index companies for calendar 2013 total shareholder return

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PSU percentage eligible for time-based vesting = the percentage of the original PSU award which will continue with service-based vesting based on the percentile ranking against total stock performance in the reference year for the health care index.

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PSU percentage eligible for vesting based on actual return = percentage of original PSU awards that continue under service-based vesting, based on percentile performance in the grant year for Total Shareholder Return

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PSU shares eligible for vesting based on actual shareholder return = No. of PSU shares that continue with service-based vesting, based on percentile performance of Total shareholder return in the calendar year of grant.

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Share-based Compensation Arrangement by Share-based Payment Award, First Year Share Vesting Rate

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Share-based Compensation Arrangement By Share-based Payment Award, Number Of Shares Eligible For Vesting

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Represents the expense recognized during the period arising from equity-based compensation arrangements (for example, shares of stock, unit, stock options or other equity instruments) with employees, directors and certain consultants qualifying for treatment as employees.

+ References

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-Publisher FASB

-Name Accounting Standards Codification

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-SubTopic 10

-Section 50

-Paragraph 1

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Aggregate number of common shares reserved for future issuance.

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Unrecognized cost of unvested share-based compensation awards.

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Weighted average period over which unrecognized compensation is expected to be recognized for equity-based compensation plans, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.

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Unrecognized cost of unvested share-based awards, other than options, awarded to employees as compensation.

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The number of grants made during the period on other than stock (or unit) option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, performance target plan).

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Amount of accumulated difference between fair value of underlying shares on dates of exercise and exercise price on options exercised (or share units converted) into shares.

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Number of share instruments newly issued under a share-based compensation plan.

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