Income Taxes Effective tax rate (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value of contingent earn-out	$ (3,947)	$ (15,572)	$ (3,991)	$ (12,256)
ReturntoProvision	1,600	7,500	1,600	7,500
contingent consideration, tax expense		0		0
Share-based Payment Arrangement, Expense, Tax Benefit	800	600	3,800	800
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount	22,400		42,900
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	$ 0	$ 0	$ 4,000	$ 6,000
Effective Income Tax Rate	(84.00%)	235.00%	(26.00%)	70.00%
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent			21.00%	21.00%
ReturntoProvision	$ 1,600	$ 7,500	$ 1,600	$ 7,500
SmithsMedical
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value of contingent earn-out		$ 15,600		$ 12,300