CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands	6 Months Ended
Jun. 30, 2011	Jun. 30, 2010
Cash Flows from Operating Activities:
Net income	$ 9,029	$ 638
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	3,234	2,902
Amortization of intangible assets	970	1,073
Provision for doubtful accounts and billing adjustments	484	175
Stock-based compensation	3,246	3,219
Amortization of deferred loan costs	231	510
Gain (loss)on officers' life insurance policies	(55)	98
Gross excess tax benefits from stock-based compensation	(535)	(72)
(Gain) loss on disposal of property and equipment	19	(30)
Settlement of earn-out	(1,369)	0
Workers' compensation and medical malpractice provision	1,491	1,989
Changes in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable	(13,626)	(1,424)
Prepaid expenses	512	821
Prepaid income taxes	(92)	3,046
Accounts payable	1,718	620
Accrued payroll and contract professional pay	5,119	3,235
Income taxes payable	1,497	0
Deferred compensation	(66)	(107)
Workers' compensation and medical malpractice loss reserves	(718)	(1,840)
Tenant improvement allowances	1,189	0
Other	667	(380)
Net cash provided by operating activities	12,945	14,473
Cash Flows from Investing Activities:
Purchase of property and equipment	(4,672)	(2,836)
Net cash paid for acquisitions	(17,107)	(5,361)
Other	278	149
Net cash used in investing activities	(21,501)	(8,048)
Cash Flows from Financing Activities:
Principal payments of long-term debt	(15,000)	0
Proceeds from borrowings on revolving credit facility	25,500	0
Proceeds from stock transactions	1,455	156
Payments of employment taxes related to release of restricted stock awards	(1,619)	(684)
Gross excess tax benefits from stock-based compensation	535	72
Payments for previous acquisitions	(22)	(22)
Payments of accrued earn-outs	(1,731)	(34)
Net cash provided by (used in) financing activities	9,118	(512)
Effect of exchange rate changes on cash and cash equivalents	212	(1,404)
Net Increase in Cash and Cash Equivalents	774	4,509
Cash and Cash Equivalents at Beginning of Year	18,409	25,974
Cash and Cash Equivalents at End of Period	19,183	30,483
Supplemental Disclosure of Cash Flow Information:
Income taxes, net of refunds	5,078	(2,450)
Interest	1,355	2,872
Supplemental Disclosure of Non-Cash Transactions:
Accrued earn-out	7,266	2,300
Acquisition of property and equipment through accounts payable	$ 327	$ 408

The net change of the provision for obligations and payables pertaining to claims incurred of a workers compensation and medical malpractice provision.

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The component of interest expense comprised of the periodic charge against earnings over the life of the financing arrangement to which such costs relate.

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The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets. As a noncash expense, this element is added back to net income when calculating cash provided by (used in) operations using the indirect method.

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Future cash outflow to pay for purchases of fixed assets that have occurred.

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Includes currency on hand as well as demand deposits with banks or financial institutions. It also includes other kinds of accounts that have the general characteristics of demand deposits in that the Entity may deposit additional funds at any time and also effectively may withdraw funds at any time without prior notice or penalty. Cash equivalents, excluding items classified as marketable securities, include short-term, highly liquid investments that are both readily convertible to known amounts of cash, and so near their maturity that they present minimal risk of changes in value because of changes in interest rates. Generally, only investments with original maturities of three months or less qualify under that definition. Original maturity means original maturity to the entity holding the investment. For example, both a three-month US Treasury bill and a three-year Treasury note purchased three months from maturity qualify as cash equivalents. However, a Treasury note purchased three years ago does not become a cash equivalent when its remaining maturity is three months. Compensating balance arrangements that do not legally restrict the withdrawal or usage of cash amounts may be reported as Cash and Cash Equivalents, while legally restricted deposits held as compensating balances against borrowing arrangements, contracts entered into with others, or company statements of intention with regard to particular deposits should not be reported as cash and cash equivalents.

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The net change between the beginning and ending balance of cash and cash equivalents.

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The amount of expense recognized in the current period that reflects the allocation of the cost of tangible assets over the assets' useful lives. Includes production and non-production related depreciation.

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The effect of exchange rate changes on cash balances held in foreign currencies.

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Reductions in the entity's income taxes that arise when compensation cost (from non-qualified share-based compensation) recognized on the entity's tax return exceeds compensation cost from share-based compensation recognized in financial statements. This element represents the cash inflow reported in the enterprise's financing activities.

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The difference between the sale price or salvage price and the book value of a property, plant, and equipment asset that was sold or retired during the reporting period. This element refers to the gain (loss).

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The amount of cash paid during the current period to foreign, federal, state, and local authorities as taxes on income, net of any cash received during the current period as refunds for the overpayment of taxes.

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The net change during the reporting period in the aggregate amount of obligations due within one year (or one business cycle). This may include trade payables, amounts due to related parties, royalties payable, and other obligations.

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The net change during the reporting period in amount due within one year (or one business cycle) from customers for the credit sale of goods and services.

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The net change during the period in the amount of cash payments due to taxing authorities for taxes that are based on the reporting entity's earnings.

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Net change during the period in the amount of salaries accrued at the period end.

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The net change during the reporting period in the obligation created by employee agreements whereby earned compensation will be paid in the future.

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The net change during the reporting period in the account that represents the temporary difference that results from income (loss) that is recognized for accounting purposes but not for tax purposes and vice versa.

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The net change in the beginning and end of period Life Insurance Liabilities balances; shall be classified as cash flows from operating activities.

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The net change during the reporting period in other obligations or expenses incurred but not yet paid. This element may be used when there is no other more specific or appropriate element.

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For entities with classified balance sheets, the net change during the reporting period in the value of other assets or liabilities used in operating activities, that are not otherwise defined in the taxonomy. For entities with unclassified balance sheets, the net change during the reporting period in the value of all other assets or liabilities used in operating activities.

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The net change during the reporting period in other operating obligations not otherwise defined in the taxonomy.

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The net change during the reporting period in the amount of outstanding money paid in advance for goods or services that bring economic benefits for future periods.

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The net change during the reporting period in the amount due for insurance (or actual expenses) to cover the medical expenses and lost income for employees that are injured during the course of doing work-related activities.

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The amount of cash paid during the current period for interest owed on money borrowed, net of interest capitalized.

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The fair value of liabilities assumed in Noncash investing or financing activities.

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The net cash inflow (outflow) from financing activity for the period.

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The net cash inflow (outflow) from investing activity.

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The net cash from (used in) all of the entity's operating activities, including those of discontinued operations, of the reporting entity. Operating activities generally involve producing and delivering goods and providing services. Operating activity cash flows include transactions, adjustments, and changes in value that are not defined as investing or financing activities.

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The net cash from (used in) all of the entity's operating activities, including those of discontinued operations, of the reporting entity. Operating activities include all transactions and events that are not defined as investing or financing activities. Operating activities generally involve producing and delivering goods and providing services. Cash flows from operating activities are generally the cash effects of transactions and other events that enter into the determination of net income.

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The portion of consolidated profit or loss for the period, net of income taxes, which is attributable to the parent. If the entity does not present consolidated financial statements, the amount of profit or loss for the period, net of income taxes.

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The amount of cash paid during the current period for taxes other than income taxes.

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The net cash outflow (inflow) from other investing activities. This element is used when there is not a more specific and appropriate element in the taxonomy.

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The net cash inflow or (outflow) associated with the aggregate amount of adjustment to the purchase price of a previous acquisition.

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The cash outflow associated with the acquisition of a business, net of the cash acquired from the purchase.

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The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets.

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The cash inflow from the issuance of common, preferred, and treasury stocks, stock options, and such forth.

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The cash inflow from a contractual arrangement with the lender, including letter of credit, standby letter of credit and revolving credit arrangements, under which borrowings can be made up to a specific amount at any point in time with maturities due beyond one year or the operating cycle, if longer.

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Period Type:	duration

- Definition

Amount of the current period expense charged against operations, the offset which is generally to the allowance for doubtful accounts for the purpose of reducing receivables, including notes receivable, to an amount that approximates their net realizable value (the amount expected to be collected).

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Statement of Financial Accounting Standard (FAS)
-Number 95
-Paragraph 28

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher SEC
-Name Regulation S-X (SX)
-Number 210
-Section 03
-Paragraph 5
-Article 5

+ Details

Name:	us-gaap_ProvisionForDoubtfulAccounts
Namespace Prefix:	us-gaap
Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	duration

- Definition

The cash outflow for debt initially having maturity due after one year or beyond the normal operating cycle, if longer.

+ References

+ Details

Name:	us-gaap_RepaymentsOfLongTermDebt
Namespace Prefix:	us-gaap
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration

- Definition

The cash outflow for borrowing not otherwise defined in the taxonomy (with maturities initially due after one year or beyond the operating cycle if longer).

+ References

+ Details

Name:	us-gaap_RepaymentsOfOtherLongTermDebt
Namespace Prefix:	us-gaap
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration

- Definition

The aggregate amount of noncash, equity-based employee remuneration. This may include the value of stock options, amortization of restricted stock, and adjustment for officers compensation. As noncash, this element is an add back when calculating net cash generated by operating activities using the indirect method.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Statement of Financial Accounting Standard (FAS)
-Number 95
-Paragraph 28

+ Details

Name:	us-gaap_ShareBasedCompensation
Namespace Prefix:	us-gaap
Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	duration

- Details

Name:	us-gaap_SupplementalCashFlowInformationAbstract
Namespace Prefix:	us-gaap
Data Type:	xbrli:stringItemType
Balance Type:	na
Period Type:	duration