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Stock Option Plans and Share-Based Compensation - Narrative (Details) (USD $) | 3 Months Ended | 9 Months Ended | 3 Months Ended | 9 Months Ended | 3 Months Ended | 9 Months Ended |  | 0 Months Ended | 12 Months Ended | 0 Months Ended | 3 Months Ended | 9 Months Ended | 3 Months Ended | 9 Months Ended |  | 9 Months Ended | 3 Months Ended
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Sep. 30, 2014 | Sep. 30, 2013 | Sep. 30, 2014 | Sep. 30, 2013 | Sep. 30, 2014 Restricted Stock | Sep. 30, 2014 Restricted Stock | Sep. 30, 2014 Performance-Based Restricted Stock Units | Sep. 30, 2013 Performance-Based Restricted Stock Units | Sep. 30, 2014 Performance-Based Restricted Stock Units | Sep. 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 | Sep. 30, 2014 Performance-Based Restricted Stock Units 2013 PSU | Sep. 30, 2014 Employee Stock [Member] | Sep. 30, 2014 Employee Stock [Member] | Sep. 30, 2014 2009 Equity Incentive Plan | Sep. 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 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 619,616 | 619,616 | 2,238,383 |  |  |
Compensation cost not yet recognized |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | $ 5,800,000 |  |
Compensation cost not yet recognized, period for recognition |  |  |  |  | 2 years 6 months |  |  |  | 1 year 3 months 6 days |  |  |  |  |  |  |  |  |  |  | 2 years 7 months 6 days |  |
Options, exercises in period, intrinsic value | 2,500,000 |  | 10,400,000 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Compensation costs not yet recognized |  |  |  |  | 6,800,000 | 6,800,000 | 1,800,000 |  | 1,800,000 |  |  |  |  |  |  |  |  |  |  |  |  |
Awards granted |  |  |  |  |  | 38,000 |  |  | 155,000 |  |  |  | 125,000 |  | 132,500 | 152,500 |  |  |  |  |  |
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 | $ 3,161,000 | $ 2,810,000 | $ 8,610,000 | $ 8,423,000 |  |  | $ 500,000 | $ 400,000 | $ 1,500,000 | $ 1,200,000 |  |  |  |  |  |  |  |  |  |  |  |
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 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 227,275 | 481,284 |  |  |  |

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- Definition 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 + References No definition available. + Details
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- Definition 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. + References No definition available. + Details
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- Definition 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 + References No definition available. + Details
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- Definition 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 Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 1 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5047-113901 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SAB TOPIC 14.F) -URI http://asc.fasb.org/extlink&oid=27013229&loc=d3e301413-122809 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (h)(1)(i) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Staff Accounting Bulletin (SAB) -Number Topic 14 -Section F + Details
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- Definition 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. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (i) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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- Definition 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). + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (c)(2)(iii)(1) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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- Definition 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. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (d)(2) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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