Quarterly report pursuant to sections 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, unless otherwise specified
Sep. 30, 2013
Dec. 31, 2012
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Total nonamortizable and amortizable intangible assets, Gross Assets $ 37,867 $ 37,361
Total nonamortizable and amortizable intangible assets, Accumulated Amortization 13,792 11,820
Total nonamortizable and amortizable intangible assets, Net 24,075 25,541
Physician and Customer Relationships [Member]
    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 32,866 32,866
Amortizable intangible assets, Accumulated Amortization 12,016 10,373
Amortizable intangible assets, Net 20,850 22,493
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 576 441
Amortizable intangible assets, Net 272 407
Software [Member]
    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 2,153 1,647
Amortizable intangible assets, Accumulated Amortization 1,200 1,006
Amortizable intangible assets, Net 953 641
Trade Names [Member]
    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Nonamortizable intangible assets $ 2,000 $ 2,000