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Pay vs Performance Disclosure - USD ($)
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Oct. 01, 2022
Jul. 01, 2022
Apr. 01, 2022
Oct. 01, 2021
Jul. 01, 2021
Apr. 01, 2021
Oct. 01, 2020
Jul. 01, 2020
Apr. 01, 2020
Dec. 31, 2019
Pay vs Performance Disclosure [Table]                          
Pay vs Performance [Table Text Block]
PAY VERSUS PERFORMANCE

The Company’s compensation objectives and philosophy, which are discussed further above, are designed to reward the contributions of its NEOs to the Company’s financial performance and provide compensation which is sufficient to attract and retain individuals who are motivated to contribute to the Company’s financial performance. To achieve these goals, the Company has implemented incentive plans which tie a significant portion of each NEO’s compensation to pre-determined financial goals.

For the year ended December 31, 2022, the most important financial performance measures used by the Company to link executive compensation actually paid to the Company’s financial performance was After-tax Operating Results.

The following table summarizes the executive compensation earned by the Company’s PEO and other NEOs, the executive compensation actually paid to the Company’s PEO and other NEOs, and certain financial performance measures of the Company for the years ended December 31, 2022, 2021, and 2020.
Year(1)
 ​ ​
Summary
Compensation
Table Total for
PEO(1)
($)
 ​ ​
Compensation
Actually Paid to
PEO(5)
($)
 ​ ​
Average
Summary
Compensation
Table Total for
non-PEO NEOs(1)
($)
 ​ ​
Average
Compensation
Actually Paid to
non-PEO NEOs(5)
($)
 ​ ​
Value of Initial
Fixed $100
Investmestment
Based on
 ​ ​
Net Income(2)
($)
 ​ ​

Operating Results(3)
($)
​
Total
Shareholder
Return
($)
 ​ ​
Peer Group
Total
Shareholder
Return(4)
($)
 ​
2022
 ​ ​
2,408,584
 ​ ​
1,859,559
 ​ ​
1,122,465
 ​ ​
920,090
 ​ ​
105
 ​ ​
111
 ​ ​
43,407,000
 ​ ​
35,034,000
2021
 ​ ​
4,143,576
 ​ ​
3,275,545
 ​ ​
1,454,841
 ​ ​
1,110,753
 ​ ​
84
 ​ ​
135
 ​ ​
57,924,000
 ​ ​
43,732,000
2020
 ​ ​
2,961,147
 ​ ​
2,446,657
 ​ ​
1,056,375
 ​ ​
829,949
 ​ ​
71
 ​ ​
130
 ​ ​
52,491,000
 ​ ​
38,435,000
(1)
The PEO is Christopher J. Reading for each of the years presented. The non-PEO NEOs are Carey P. Hendrickson, Eric J. Williams, Graham D. Reeve, and Richard Binstein for 2022, Carey P. Hendrickson, Eric J. Williams, Glenn D. McDowell, and Graham D. Reeve for 2021 and Carey P. Hendrickson, Lawrance W. MacAfee, Glenn D. McDowell, and Graham D. Reeve for 2020.
(2)
Net income includes earnings attributable to both controlling and non-controlling interests.
(3)
Operating Results, a non-GAAP measure, for the years ended December 31, 2022, 2021 and 2020 equals net income attributable to our diluted shareholders per the consolidated statements of income, adjusted for unusual, non-recurring and non-operational charges including: revaluation of redeemable non-controlling interest, goodwill impairment, changes in fair value of contingent consideration, expenses related to executive officer transitions, settlement of a legal matter, and any applicable allocations to non-controlling interests of such items, all net of taxes. In addition, Operating Results for the year ended December 31, 2020, excludes clinic closure costs and the gain on sale of partnership interests and clinics mainly resulting from the COVID-19 pandemic. A detailed calculation of Operating Results can be found in Part II, Item 7 of the Company's Annual Report on Form 10-K for the years ended December 31, 2022, and December 31, 2021.
(4)
The Total Shareholder Return assumes that $100 was invested in our common stock and the common stock on each of the companies listed on The NYSE Heathcare Index (the Company’s Peer Group), on December 31, 2019 and that any dividends were reinvested.
(5)
For a computation of compensation actually paid to PEO and average compensation actually paid to non-PEO NEOs, please refer to the subsequent table.

The following table outlines the adjustments made to the compensation earned by the Company’s PEO and other NEOs, as presented in the Summary Compensation Table on page 30, to derive the compensation actually paid to the Company’s PEO and other NEOs.
Year
 ​ ​
 
 ​ ​
Adjustments
​
Summary
Compensation
Table Total
($)
 ​ ​
Less: Reported
Value of Stock
Awards
($)(1)
 ​ ​
Plus: Year End
Fair Value of
Restricted
Stock Awards
Granted
During the Year
($)(2)(3)
 ​ ​
Plus: Change in
Fair Value of
Outstanding and
Unvested
Restricted Stock
Awards
($)(2)(3)
 ​ ​
Plus: Changes in
Fair Value of
Restricted
Stock in
Prior Years
that Vested
During the Year
Year
($)(2)(3)
 ​ ​
Dividends
paid on
Unvested
Restricted
Stock
Awards
During the
Fiscal Year
($)(4)
 ​ ​
Compensation
Actually
Paid
($)
PEO
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
2022
 ​ ​
2,408,584
 ​ ​
1,016,800
 ​ ​
810,300
 ​ ​
(411,395)
 ​ ​
22,404
 ​ ​
46,466
 ​ ​
1,859,559
2021
 ​ ​
4,143,576
 ​ ​
2,120,100
 ​ ​
1,911,000
 ​ ​
(613,844)
 ​ ​
(81,371)
 ​ ​
36,284
 ​ ​
3,275,545
2020
 ​ ​
2,961,147
 ​ ​
1,533,056
 ​ ​
1,346,800
 ​ ​
180,251
 ​ ​
(518,261)
 ​ ​
9,776
 ​ ​
2,446,657
Non-PEO
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
2022
 ​ ​
1,122,465
 ​ ​
444,850
 ​ ​
354,506
 ​ ​
(132,671)
 ​ ​
5,768
 ​ ​
14,872
 ​ ​
920,090
2021
 ​ ​
1,454,841
 ​ ​
706,539
 ​ ​
537,469
 ​ ​
(157,849)
 ​ ​
(26,493)
 ​ ​
9,325
 ​ ​
1,110,753
2020
 ​ ​
1,056,375
 ​ ​
484,122
 ​ ​
447,571
 ​ ​
63,051
 ​ ​
(256,345)
 ​ ​
3,419
 ​ ​
829,949
(1)
Represents the grant date fair value of restricted stock awards earned and as reported in the “Stock Awards” column of the Summary Compensation Table for each applicable year. These shares were issued in March of the succeeding year.
(2)
Adjustments are equal to (i) the year-end fair value of restricted stock awards granted during the applicable year that are earned but not issued and therefore deemed outstanding and unvested as of the end of the year, (ii) the amount of the change in fair value as of the end of the applicable year (from the end of the prior fiscal year) of any restricted stock awards granted in prior years that are outstanding and unvested as of the end of the applicable year, and (iii) for restricted stock awards granted in prior years that vest in the applicable year, an amount equal to the change in fair value as of the vesting date (from the end of the prior fiscal year).
(3)
Restricted stock awards are valued using the market price of our stock. The closing market price of our stock was $81.03, $95.55, $120.25, and $114.35 as of December 31, 2022, 2021, 2020, and 2019, respectively. The closing market price of our stock when the PEO and other NEOs’ restricted stock awards vested was $95.55 on January 1, 2022, $103.76 on April 1, 2022, $112.30 on July 1, 2022, $760.02 on October 1, 2022, $120.25 on January 1, 2021, $110.21 on April 1, 2021, $119.34 on July 1, 2021, $111.55 on October 1, 2021, $114.35 on January 1, 2020, $59.00 on April 1, 2020, $81.02 on July 1, 2020 and $86.88 on October 1, 2020.
(4)
Includes dividends paid and declared on outstanding and unvested shares as of December 31, 2022, 2021 and 2020. Dividends declared per common share were $1.64, $1.46, and $0.32 for the fiscal years ended December 31, 2022, 2021 and 2020, respectively.
                       
Company Selected Measure Name Operating Results                        
Named Executive Officers, Footnote [Text Block]
(1)
The PEO is Christopher J. Reading for each of the years presented. The non-PEO NEOs are Carey P. Hendrickson, Eric J. Williams, Graham D. Reeve, and Richard Binstein for 2022, Carey P. Hendrickson, Eric J. Williams, Glenn D. McDowell, and Graham D. Reeve for 2021 and Carey P. Hendrickson, Lawrance W. MacAfee, Glenn D. McDowell, and Graham D. Reeve for 2020.
                       
Peer Group Issuers, Footnote [Text Block]
(4)
The Total Shareholder Return assumes that $100 was invested in our common stock and the common stock on each of the companies listed on The NYSE Heathcare Index (the Company’s Peer Group), on December 31, 2019 and that any dividends were reinvested.
                       
PEO Total Compensation Amount $ 2,408,584 $ 4,143,576 $ 2,961,147                    
PEO Actually Paid Compensation Amount $ 1,859,559 3,275,545 2,446,657                    
Adjustment To PEO Compensation, Footnote [Text Block]
(5)
For a computation of compensation actually paid to PEO and average compensation actually paid to non-PEO NEOs, please refer to the subsequent table.

The following table outlines the adjustments made to the compensation earned by the Company’s PEO and other NEOs, as presented in the Summary Compensation Table on page 30, to derive the compensation actually paid to the Company’s PEO and other NEOs.
Year
 ​ ​
 
 ​ ​
Adjustments
​
Summary
Compensation
Table Total
($)
 ​ ​
Less: Reported
Value of Stock
Awards
($)(1)
 ​ ​
Plus: Year End
Fair Value of
Restricted
Stock Awards
Granted
During the Year
($)(2)(3)
 ​ ​
Plus: Change in
Fair Value of
Outstanding and
Unvested
Restricted Stock
Awards
($)(2)(3)
 ​ ​
Plus: Changes in
Fair Value of
Restricted
Stock in
Prior Years
that Vested
During the Year
Year
($)(2)(3)
 ​ ​
Dividends
paid on
Unvested
Restricted
Stock
Awards
During the
Fiscal Year
($)(4)
 ​ ​
Compensation
Actually
Paid
($)
PEO
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
2022
 ​ ​
2,408,584
 ​ ​
1,016,800
 ​ ​
810,300
 ​ ​
(411,395)
 ​ ​
22,404
 ​ ​
46,466
 ​ ​
1,859,559
2021
 ​ ​
4,143,576
 ​ ​
2,120,100
 ​ ​
1,911,000
 ​ ​
(613,844)
 ​ ​
(81,371)
 ​ ​
36,284
 ​ ​
3,275,545
2020
 ​ ​
2,961,147
 ​ ​
1,533,056
 ​ ​
1,346,800
 ​ ​
180,251
 ​ ​
(518,261)
 ​ ​
9,776
 ​ ​
2,446,657
Non-PEO
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
2022
 ​ ​
1,122,465
 ​ ​
444,850
 ​ ​
354,506
 ​ ​
(132,671)
 ​ ​
5,768
 ​ ​
14,872
 ​ ​
920,090
2021
 ​ ​
1,454,841
 ​ ​
706,539
 ​ ​
537,469
 ​ ​
(157,849)
 ​ ​
(26,493)
 ​ ​
9,325
 ​ ​
1,110,753
2020
 ​ ​
1,056,375
 ​ ​
484,122
 ​ ​
447,571
 ​ ​
63,051
 ​ ​
(256,345)
 ​ ​
3,419
 ​ ​
829,949
(1)
Represents the grant date fair value of restricted stock awards earned and as reported in the “Stock Awards” column of the Summary Compensation Table for each applicable year. These shares were issued in March of the succeeding year.
(2)
Adjustments are equal to (i) the year-end fair value of restricted stock awards granted during the applicable year that are earned but not issued and therefore deemed outstanding and unvested as of the end of the year, (ii) the amount of the change in fair value as of the end of the applicable year (from the end of the prior fiscal year) of any restricted stock awards granted in prior years that are outstanding and unvested as of the end of the applicable year, and (iii) for restricted stock awards granted in prior years that vest in the applicable year, an amount equal to the change in fair value as of the vesting date (from the end of the prior fiscal year).
(3)
Restricted stock awards are valued using the market price of our stock. The closing market price of our stock was $81.03, $95.55, $120.25, and $114.35 as of December 31, 2022, 2021, 2020, and 2019, respectively. The closing market price of our stock when the PEO and other NEOs’ restricted stock awards vested was $95.55 on January 1, 2022, $103.76 on April 1, 2022, $112.30 on July 1, 2022, $760.02 on October 1, 2022, $120.25 on January 1, 2021, $110.21 on April 1, 2021, $119.34 on July 1, 2021, $111.55 on October 1, 2021, $114.35 on January 1, 2020, $59.00 on April 1, 2020, $81.02 on July 1, 2020 and $86.88 on October 1, 2020.
(4)
Includes dividends paid and declared on outstanding and unvested shares as of December 31, 2022, 2021 and 2020. Dividends declared per common share were $1.64, $1.46, and $0.32 for the fiscal years ended December 31, 2022, 2021 and 2020, respectively.
                       
Non-PEO NEO Average Total Compensation Amount $ 1,122,465 1,454,841 1,056,375                    
Non-PEO NEO Average Compensation Actually Paid Amount $ 920,090 1,110,753 829,949                    
Adjustment to Non-PEO NEO Compensation Footnote [Text Block]
(5)
For a computation of compensation actually paid to PEO and average compensation actually paid to non-PEO NEOs, please refer to the subsequent table.

The following table outlines the adjustments made to the compensation earned by the Company’s PEO and other NEOs, as presented in the Summary Compensation Table on page 30, to derive the compensation actually paid to the Company’s PEO and other NEOs.
Year
 ​ ​
 
 ​ ​
Adjustments
​
Summary
Compensation
Table Total
($)
 ​ ​
Less: Reported
Value of Stock
Awards
($)(1)
 ​ ​
Plus: Year End
Fair Value of
Restricted
Stock Awards
Granted
During the Year
($)(2)(3)
 ​ ​
Plus: Change in
Fair Value of
Outstanding and
Unvested
Restricted Stock
Awards
($)(2)(3)
 ​ ​
Plus: Changes in
Fair Value of
Restricted
Stock in
Prior Years
that Vested
During the Year
Year
($)(2)(3)
 ​ ​
Dividends
paid on
Unvested
Restricted
Stock
Awards
During the
Fiscal Year
($)(4)
 ​ ​
Compensation
Actually
Paid
($)
PEO
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
2022
 ​ ​
2,408,584
 ​ ​
1,016,800
 ​ ​
810,300
 ​ ​
(411,395)
 ​ ​
22,404
 ​ ​
46,466
 ​ ​
1,859,559
2021
 ​ ​
4,143,576
 ​ ​
2,120,100
 ​ ​
1,911,000
 ​ ​
(613,844)
 ​ ​
(81,371)
 ​ ​
36,284
 ​ ​
3,275,545
2020
 ​ ​
2,961,147
 ​ ​
1,533,056
 ​ ​
1,346,800
 ​ ​
180,251
 ​ ​
(518,261)
 ​ ​
9,776
 ​ ​
2,446,657
Non-PEO
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
 ​ ​
 
2022
 ​ ​
1,122,465
 ​ ​
444,850
 ​ ​
354,506
 ​ ​
(132,671)
 ​ ​
5,768
 ​ ​
14,872
 ​ ​
920,090
2021
 ​ ​
1,454,841
 ​ ​
706,539
 ​ ​
537,469
 ​ ​
(157,849)
 ​ ​
(26,493)
 ​ ​
9,325
 ​ ​
1,110,753
2020
 ​ ​
1,056,375
 ​ ​
484,122
 ​ ​
447,571
 ​ ​
63,051
 ​ ​
(256,345)
 ​ ​
3,419
 ​ ​
829,949
(1)
Represents the grant date fair value of restricted stock awards earned and as reported in the “Stock Awards” column of the Summary Compensation Table for each applicable year. These shares were issued in March of the succeeding year.
(2)
Adjustments are equal to (i) the year-end fair value of restricted stock awards granted during the applicable year that are earned but not issued and therefore deemed outstanding and unvested as of the end of the year, (ii) the amount of the change in fair value as of the end of the applicable year (from the end of the prior fiscal year) of any restricted stock awards granted in prior years that are outstanding and unvested as of the end of the applicable year, and (iii) for restricted stock awards granted in prior years that vest in the applicable year, an amount equal to the change in fair value as of the vesting date (from the end of the prior fiscal year).
(3)
Restricted stock awards are valued using the market price of our stock. The closing market price of our stock was $81.03, $95.55, $120.25, and $114.35 as of December 31, 2022, 2021, 2020, and 2019, respectively. The closing market price of our stock when the PEO and other NEOs’ restricted stock awards vested was $95.55 on January 1, 2022, $103.76 on April 1, 2022, $112.30 on July 1, 2022, $760.02 on October 1, 2022, $120.25 on January 1, 2021, $110.21 on April 1, 2021, $119.34 on July 1, 2021, $111.55 on October 1, 2021, $114.35 on January 1, 2020, $59.00 on April 1, 2020, $81.02 on July 1, 2020 and $86.88 on October 1, 2020.
(4)
Includes dividends paid and declared on outstanding and unvested shares as of December 31, 2022, 2021 and 2020. Dividends declared per common share were $1.64, $1.46, and $0.32 for the fiscal years ended December 31, 2022, 2021 and 2020, respectively.
                       
Compensation Actually Paid vs. Total Shareholder Return [Text Block]
Relationship between Pay and TSR

The graph below illustrates the relationship between compensation actually paid to the Company’s PEO and other NEOs, the cumulative total stockholder return (“TSR”) on $100 invested in the Company at the close of the market on December 31, 2019, with dividends being reinvested on the date paid through December 31, 2022, and the cumulative TSR of the NYSE Health Care Index. The NYSE Health Care Index TSR is calculated in a similar manner as the Company’s TSR.
graphic
 
                        
Compensation Actually Paid vs. Net Income [Text Block]
Relationship between Pay and Net Income

The graph below illustrates the relationship between compensation actually paid to the Company’s PEO and other NEOs and the Company’s net income.
graphic
 
                        
Compensation Actually Paid vs. Company Selected Measure [Text Block]
Relationship between Pay and Operating Results

The graph below illustrates the relationship between compensation actually paid to the Company’s PEO and other NEOs and the Company’s Operating Results.
graphic
 
                        
Total Shareholder Return Vs Peer Group [Text Block]
Relationship between Pay and TSR

The graph below illustrates the relationship between compensation actually paid to the Company’s PEO and other NEOs, the cumulative total stockholder return (“TSR”) on $100 invested in the Company at the close of the market on December 31, 2019, with dividends being reinvested on the date paid through December 31, 2022, and the cumulative TSR of the NYSE Health Care Index. The NYSE Health Care Index TSR is calculated in a similar manner as the Company’s TSR.
graphic
 
                        
Tabular List [Table Text Block]

For the year ended December 31, 2022, the most important financial performance measures used by the Company to link executive compensation actually paid to the Company’s financial performance was After-tax Operating Results.
                        
Total Shareholder Return Amount $ 105 84 71                    
Peer Group Total Shareholder Return Amount 111 135 130                    
Net Income (Loss) $ 43,407,000 $ 57,924,000 $ 52,491,000                    
Company Selected Measure Amount 35,034,000 43,732,000 38,435,000                    
PEO Name Christopher J. Reading Christopher J. Reading Christopher J. Reading                    
Share price $ 81.03 $ 95.55 $ 120.25 $ 760.02 $ 112.3 $ 103.76 $ 111.55 $ 119.34 $ 110.21 $ 86.88 $ 81.02 $ 59 $ 114.35
Dividends declared per common share $ 1.64 $ 1.46 $ 0.32                    
Measure [Axis]: 1                          
Pay vs Performance Disclosure [Table]                          
Measure Name Operating Results                        
Non-GAAP Measure Description [Text Block]
(3)
Operating Results, a non-GAAP measure, for the years ended December 31, 2022, 2021 and 2020 equals net income attributable to our diluted shareholders per the consolidated statements of income, adjusted for unusual, non-recurring and non-operational charges including: revaluation of redeemable non-controlling interest, goodwill impairment, changes in fair value of contingent consideration, expenses related to executive officer transitions, settlement of a legal matter, and any applicable allocations to non-controlling interests of such items, all net of taxes. In addition, Operating Results for the year ended December 31, 2020, excludes clinic closure costs and the gain on sale of partnership interests and clinics mainly resulting from the COVID-19 pandemic. A detailed calculation of Operating Results can be found in Part II, Item 7 of the Company's Annual Report on Form 10-K for the years ended December 31, 2022, and December 31, 2021.
                       
PEO [Member] | Reported Value of Stock Awards [Member]                          
Pay vs Performance Disclosure [Table]                          
Adjustment to Compensation Amount $ (1,016,800) $ (2,120,100) $ (1,533,056)                    
PEO [Member] | Year End Fair Value of Restricted Stock Awards Granted During the Year [Member]                          
Pay vs Performance Disclosure [Table]                          
Adjustment to Compensation Amount 810,300 1,911,000 1,346,800                    
PEO [Member] | Change in Fair Value of Outstanding and Unvested Restricted Stock Awards [Member]                          
Pay vs Performance Disclosure [Table]                          
Adjustment to Compensation Amount (411,395) (613,844) 180,251                    
PEO [Member] | Changes in Fair Value of Restricted Stock in Prior Years that Vested During the Year [Member]                          
Pay vs Performance Disclosure [Table]                          
Adjustment to Compensation Amount 22,404 (81,371) (518,261)                    
PEO [Member] | Dividends paid on Unvested Restricted Stock Awards During the Fiscal Year [Member]                          
Pay vs Performance Disclosure [Table]                          
Adjustment to Compensation Amount 46,466 36,284 9,776                    
Non-PEO NEO [Member] | Reported Value of Stock Awards [Member]                          
Pay vs Performance Disclosure [Table]                          
Adjustment to Compensation Amount (444,850) (706,539) (484,122)                    
Non-PEO NEO [Member] | Year End Fair Value of Restricted Stock Awards Granted During the Year [Member]                          
Pay vs Performance Disclosure [Table]                          
Adjustment to Compensation Amount 354,506 537,469 447,571                    
Non-PEO NEO [Member] | Change in Fair Value of Outstanding and Unvested Restricted Stock Awards [Member]                          
Pay vs Performance Disclosure [Table]                          
Adjustment to Compensation Amount (132,671) (157,849) 63,051                    
Non-PEO NEO [Member] | Changes in Fair Value of Restricted Stock in Prior Years that Vested During the Year [Member]                          
Pay vs Performance Disclosure [Table]                          
Adjustment to Compensation Amount 5,768 (26,493) (256,345)                    
Non-PEO NEO [Member] | Dividends paid on Unvested Restricted Stock Awards During the Fiscal Year [Member]                          
Pay vs Performance Disclosure [Table]                          
Adjustment to Compensation Amount $ 14,872 $ 9,325 $ 3,419