Changes in Carrying Amount of Goodwill by Segment (Detail) (USD $)	3 Months Ended				12 Months Ended
	Dec. 31, 2012		Sep. 30, 2012	Jun. 30, 2012	Dec. 31, 2013	Dec. 31, 2008
Goodwill balances
Goodwill, net of impairment loss					$ 62,712,109
Aggregate goodwill acquired	322,444,517				336,998,315
Accumulated impairment loss	(259,732,408)				(259,732,408)	(241,000,000)
Goodwill, net of impairment loss	62,712,109				77,265,907
Changes to aggregate goodwill in 2013
Goodwill acquired					14,553,798
Impairment charges	11,900,000		23,500,000	18,732,000
Nurse and allied staffing [Member]
Goodwill balances
Goodwill, net of impairment loss					0
Aggregate goodwill acquired	259,732,408				274,286,206
Accumulated impairment loss	(259,732,408)	[1]			(259,732,408)
Goodwill, net of impairment loss					14,553,798
Changes to aggregate goodwill in 2013
Goodwill acquired					14,553,798
Physician Staffing [Member]
Goodwill balances
Goodwill, net of impairment loss					43,405,047
Aggregate goodwill acquired	43,405,047				43,405,047
Accumulated impairment loss	0				0
Goodwill, net of impairment loss					43,405,047
Changes to aggregate goodwill in 2013
Goodwill acquired					0
Other human capital management services [Member]
Goodwill balances
Goodwill, net of impairment loss					19,307,062
Aggregate goodwill acquired	19,307,062				19,307,062
Accumulated impairment loss	0				0
Goodwill, net of impairment loss					19,307,062
Changes to aggregate goodwill in 2013
Goodwill acquired					$ 0

[1] A non-cash pretax impairment charge of approximately $241,000,000 was recorded to reduce the carrying value of goodwill to its estimated fair value in the fourth quarter of 2008 for its nurse and allied staffing business segment. The majority of the goodwill impairment was attributable to the Company’s initial capitalization in 1999, which was accounted for as an asset purchase (see Note 1 – Organization and Basis of Presentation), and subsequent nurse staffing acquisitions made through 2003. In addition, in the second quarter of 2012, a non-cash pretax impairment charge of approximately $18,732,000 was recorded for the Company’s nurse and allied staffing reporting unit. See impairment review disclosures that follow.