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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, unless otherwise specified
Jun. 30, 2014
Dec. 31, 2013
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Total nonamortizable and amortizable intangible assets, Gross Assets $ 39,982 $ 38,620
Total nonamortizable and amortizable intangible assets, Accumulated Amortization 15,695 14,438
Total nonamortizable and amortizable intangible assets, Net 24,287 24,182
Physician and Customer Relationships [Member]
    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 32,865 32,865
Amortizable intangible assets, Accumulated Amortization 13,659 12,564
Amortizable intangible assets, Net 19,206 20,301
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 703 621
Amortizable intangible assets, Net 145 227
Software [Member]
    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 4,269 2,907
Amortizable intangible assets, Accumulated Amortization 1,333 1,253
Amortizable intangible assets, Net 2,936 1,654
Trade Names [Member]
    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Nonamortizable intangible assets $ 2,000 $ 2,000