Quarterly report pursuant to Section 13 or 15(d)

Note 5 - Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Details)

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Note 5 - Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Details) - USD ($)
$ in Thousands
Sep. 30, 2018
Dec. 31, 2017
Amortizable intangible assets, accumulated amortization $ 29,921 $ 26,409
Total nonamortizable and amortizable intangible assets, gross assets 50,923 50,923
Total nonamortizable and amortizable intangible assets, net 21,002 24,514
Trade Names [Member]    
Amortizable intangible assets, gross assets 23 23
Amortizable intangible assets, accumulated amortization 23 23
Amortizable intangible assets, net
Physician and Customer Relationships [Member]    
Amortizable intangible assets, gross assets 36,534 36,534
Amortizable intangible assets, accumulated amortization 23,582 21,801
Amortizable intangible assets, net 12,952 14,733
Noncompete Agreements [Member]    
Amortizable intangible assets, gross assets 1,136 1,136
Amortizable intangible assets, accumulated amortization 1,136 1,125
Amortizable intangible assets, net 11
Computer Software, Intangible Asset [Member]    
Amortizable intangible assets, gross assets 11,230 11,230
Amortizable intangible assets, accumulated amortization 5,180 3,460
Amortizable intangible assets, net 6,050 7,770
Trade Names 1 [Member]    
Nonamortizable intangible assets $ 2,000 $ 2,000