Annual report pursuant to Section 13 and 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
Dec. 31, 2016
Dec. 31, 2015
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Total nonamortizable and amortizable intangible assets, Gross Assets $ 53,438 $ 51,317
Total nonamortizable and amortizable intangible assets, Accumulated Amortization 22,199 19,783
Total nonamortizable and amortizable intangible assets, Net 31,239 31,534
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 15
Amortizable intangible assets, Net   8
Physician and Customer Relationships [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 36,534 36,258
Amortizable intangible assets, Accumulated Amortization 19,427 17,049
Amortizable intangible assets, Net 17,107 19,209
Non-Compete Agreements [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 1,136 1,094
Amortizable intangible assets, Accumulated Amortization 1,064 930
Amortizable intangible assets, Net 72 164
Software [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 13,745 11,942
Amortizable intangible assets, Accumulated Amortization 1,685 1,789
Amortizable intangible assets, Net 12,060 10,153
Trade Names [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Nonamortizable intangible assets $ 2,000 $ 2,000