Annual report pursuant to Section 13 and 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
Dec. 31, 2017
Dec. 31, 2016
Amortizable intangible assets, accumulated amortization $ 26,409 $ 22,199
Total nonamortizable and amortizable intangible assets, gross assets 50,923 53,438
Intangible assets, net 24,514 31,239
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 21,801 19,427
Amortizable intangible assets, net 14,733 17,107
Noncompete Agreements [Member]    
Amortizable intangible assets, gross assets 1,136 1,136
Amortizable intangible assets, accumulated amortization 1,125 1,064
Amortizable intangible assets, net 11 72
Computer Software, Intangible Asset [Member]    
Amortizable intangible assets, gross assets 11,230 13,745
Amortizable intangible assets, accumulated amortization 3,460 1,685
Amortizable intangible assets, net 7,770 12,060
Trade Names 1 [Member]    
Nonamortizable intangible assets $ 2,000 $ 2,000