Note 6 - Accrued Expenses (Details) - Accrued Expenses - USD ($) $ in Thousands	Sep. 30, 2015	Dec. 31, 2014
Accrued Expenses [Abstract]
Accrued compensation and benefits	$ 14,769	$ 15,041
Accrued selling and professional fees	3,557	4,202
Accrued income, value added and other taxes	28,248	26,576
Accrued medical panel fees	4,644	4,391
Other accrued expenses	3,056	3,768
Totals	$ 54,274	$ 53,978