Quarterly report pursuant to Section 13 or 15(d)

Goodwill and Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Detail)

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Goodwill and Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Detail) - USD ($)
$ in Thousands
Sep. 30, 2015
Dec. 31, 2014
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Total nonamortizable and amortizable intangible assets, Gross Assets $ 49,692 $ 42,012
Total nonamortizable and amortizable intangible assets, Accumulated Amortization 18,966 16,939
Total nonamortizable and amortizable intangible assets, Net 30,726 25,073
Physician and Customer Relationships [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 35,939 32,865
Amortizable intangible assets, Accumulated Amortization 16,484 14,755
Amortizable intangible assets, Net 19,456 18,110
Non-Competition Agreements [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 848 848
Amortizable intangible assets, Accumulated Amortization 848 777
Amortizable intangible assets, Net   71
Software [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 10,905 6,299
Amortizable intangible assets, Accumulated Amortization 1,634 1,407
Amortizable intangible assets, Net 9,270 4,892
Trade Names [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Nonamortizable intangible assets $ 2,000 $ 2,000