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Acquisitions and Divestiture (Details 1) (USD $)
 1 Months Ended 12 Months Ended
May 31, 2012
Jul. 31, 2011
Mar. 31, 2010
Dec. 31, 2012
Dec. 31, 2011
Dec. 31, 2010
May 22, 2012
Jul. 25, 2011
Dec. 21, 2010
Feb. 26, 2010
Schedule of preliminary purchase prices allocation                    
Cash paid, net of cash acquired $ 7,929,000 $ 7,930,000 $ 16,942,000 $ 7,929,000 $ 9,451,000 $ 18,197,000        
Seller notes 350,000 200,000 500,000     200,000 250,000,000 200,000 100,000 200,000
Total consideration 8,279,000 8,130,000 17,442,000              
Estimated fair value of net tangible assets acquired:                    
Total current assets 363,000 1,341,000 1,765,000 3,500,000 3,500,000 3,500,000        
Total non-current assets 478,000 902,000 1,308,000              
Total liabilities (290,000) (581,000) (851,000)              
Net tangible assets acquired 551,000 1,662,000 2,222,000              
Tradename   1,900,000 2,700,000              
Referral relationships 57,000 1,100,000 1,700,000 57,000            
Non compete 25,000 300,000 480,000              
Goodwill 10,538,000 11,263,000 18,471,000              
Fair value of noncontrolling interest (2,892,000) (8,095,000) (8,131,000)              
Total consideration $ 8,279,000 $ 8,130,000 $ 17,442,000