Quarterly report pursuant to Section 13 or 15(d)

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

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Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Detail) - USD ($)
$ in Thousands
Sep. 30, 2017
Dec. 31, 2016
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Total nonamortizable and amortizable intangible assets, Gross Assets $ 53,328 $ 53,438
Total nonamortizable and amortizable intangible assets, Accumulated Amortization 26,377 22,199
Total nonamortizable and amortizable intangible assets, Net 26,951 31,239
Trade Names [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 23 23
Amortizable intangible assets, Accumulated Amortization 23 23
Physician and Customer Relationships [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 36,534 36,534
Amortizable intangible assets, Accumulated Amortization 21,207 19,427
Amortizable intangible assets, Net 15,327 17,107
Non-Competition Agreements [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 1,136 1,136
Amortizable intangible assets, Accumulated Amortization 1,120 1,064
Amortizable intangible assets, Net 16 72
Software [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 13,635 13,745
Amortizable intangible assets, Accumulated Amortization 4,027 1,685
Amortizable intangible assets, Net 9,608 12,060
Trade Names [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Nonamortizable intangible assets $ 2,000 $ 2,000