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Goodwill (Details) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Goodwill [Roll Forward]      
Beginning balance $ 345,646 $ 317,676  
Goodwill acquired 89,746 28,540  
Goodwill derecognition (write-off) related to closed clinics 0 (1,859) $ 0
Goodwill adjustments for purchase price allocation of businesses acquired in prior year (713) 1,289  
Ending balance $ 434,679 $ 345,646 $ 317,676