Note 6 - Accrued Expenses (Details) - Accrued Expenses (USD $) In Thousands, unless otherwise specified	Mar. 31, 2015	Dec. 31, 2014
Accrued Expenses [Abstract]
Accrued compensation and benefits	$ 14,416	$ 15,041
Accrued selling and professional fees	3,892	4,202
Accrued income, value added and other taxes	26,954	26,576
Accrued medical panel fees	3,890exam_AccruedMedicalPanelFees	4,391exam_AccruedMedicalPanelFees
Other accrued expenses	3,293us-gaap_OtherAccruedLiabilitiesCurrent	3,768us-gaap_OtherAccruedLiabilitiesCurrent
Totals	$ 52,445us-gaap_AccruedLiabilitiesCurrent	$ 53,978us-gaap_AccruedLiabilitiesCurrent

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Carrying value as of the balance sheet date of liabilities incurred through that date and payable for income taxes and statutory sales and use taxes, including value added tax.

+ References

No definition available.

+ Details

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- Definition

Carrying value as of the balance sheet date of obligations incurred through that date and payable for fees to members of the Company's medical panel. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

+ References

No definition available.

+ Details

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- Definition

Carrying value as of the balance sheet date of obligations incurred through that date and payable for expenses directly related to the sale of services and professional fees, such as for legal and accounting services received. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

+ References

No definition available.

+ Details

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- Definition

Carrying value as of the balance sheet date of obligations incurred and payable, pertaining to costs that are statutory in nature, are incurred on contractual obligations, or accumulate over time and for which invoices have not yet been received or will not be rendered. Examples include taxes, interest, rent and utilities. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 210

-SubTopic 10

-Section S99

-Paragraph 1

-Subparagraph (SX 210.5-02.20)

-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

+ Details

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- Definition

Total of the carrying values as of the balance sheet date of obligations incurred through that date and payable for obligations related to services received from employees, such as accrued salaries and bonuses, payroll taxes and fringe benefits. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

+ References

+ Details

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- Definition

Carrying value as of the balance sheet date of obligations incurred through that date and payable arising from transactions not otherwise specified in the taxonomy. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Glossary Current Liabilities

-URI http://asc.fasb.org/extlink&oid=6509677

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 210

-SubTopic 10

-Section 45

-Paragraph 8

-URI http://asc.fasb.org/extlink&oid=28358313&loc=d3e6935-107765

Reference 3: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 210

-SubTopic 10

-Section S99

-Paragraph 1

-Subparagraph (SX 210.5-02.20)

-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

Reference 4: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 210

-SubTopic 10

-Section 45

-Paragraph 6

-URI http://asc.fasb.org/extlink&oid=28358313&loc=d3e6911-107765

Reference 5: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 210

-SubTopic 10

-Section 45

-Paragraph 9

-URI http://asc.fasb.org/extlink&oid=28358313&loc=d3e7018-107765

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