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Acquisitions Acquisitions - ADEA (Details) - USD ($)	3 Months Ended
Acquisitions Acquisitions - ADEA (Details) - USD ($)	Jun. 30, 2019	Dec. 31, 2019	Mar. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Goodwill		$ 301,321,000		$ 238,814,000	$ 223,105,000
ADEA Medical Inc
Fair value of shares issued in business acquisition	$ 2,100,000
Cash consideration	200,000
Net assets acquired	$ 3,300,000
ADEA Medical Inc \| Sales Restriction Ending 4Q2019
Number of shares issued in a business acquisition	10,000
ADEA Medical Inc \| Sales Restriction Ending 2Q2022
Number of shares issued in a business acquisition	40,000
ADEA Medical Inc
Ownership Percentage			23.80%
Healthcare
Goodwill		$ 276,014,000		$ 213,507,000	$ 198,273,000
Healthcare \| ADEA Medical Inc
Goodwill	$ 2,600,000
Goodwill, expected tax deductible amount	$ 0
Common stock \| ADEA Medical Inc
Number of shares issued in a business acquisition	50,000