CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Cash Flows from Operating Activities:
Net income (loss)	$ 24,297	$ (9,897)	$ 4,707
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation	6,505	5,881	5,731
Amortization of intangible assets	2,346	2,115	6,075
Provision for doubtful accounts and billing adjustments	1,127	644	296
Deferred income tax provision	3,748	2,274	4,287
Stock-based compensation	6,927	7,749	5,007
Amortization of deferred loan costs	460	961	894
Write-down of deferred loan costs	0	2,208	0
Change in fair value of interest rate swap	0	0	(1,345)
(Gain) loss on officers' life insurance policies	183	(212)	(478)
Gross excess tax benefits from stock-based compensation	(1,113)	(205)	(34)
Impairment of goodwill	0	15,399	0
(Gain) loss on disposal of property and equipment	61	(3)	(246)
Change in accrued earn-outs	(2,009)	0	0
Workers' compensation and medical malpractice provision	3,196	4,310	4,283
Changes in operating assets and liabilities, net of effect of acquisitions:
Accounts receivable	(25,079)	(10,532)	28,024
Prepaid expenses	(1,633)	(501)	1,076
Prepaid income taxes	(1,292)	4,223	(958)
Accounts payable	(1,812)	1,032	(695)
Accrued payroll and contract professional pay	6,400	3,880	(9,017)
Income taxes payable	(1,231)	856	0
Deferred compensation	(303)	128	460
Workers' compensation and medical malpractice loss reserves	(1,467)	(3,948)	(3,688)
Tenant improvement allowances	1,308	0	0
Other	2,800	499	(2,366)
Net cash provided by operating activities	23,419	26,861	42,013
Cash Flows from Investing Activities:
Purchase of property and equipment	(8,411)	(6,302)	(4,673)
Cash paid for acquisitions, net of cash acquired	(32,818)	(10,458)	(10,239)
Proceeds from insurance settlements	0	42	512
Other	109	137	572
Net cash used in investing activities	(41,120)	(16,581)	(13,828)
Cash Flows from Financing Activities :
Principal payments of long-term debt	(20,500)	(79,163)	(48,000)
Proceeds from term debt	40,500	68,000	0
Proceeds from stock transactions	2,701	333	555
Payment of employment taxes related to release of restricted stock awards	(2,214)	(1,955)	(325)
Gross excess tax benefits from stock-based compensation	1,113	205	34
Repurchase of Common Stock	(2,230)	(2,000)	0
Debt issuance or amendment costs	(87)	(1,938)	(1,065)
Payments of other long-term liabilities	(1,731)	(52)	(156)
Other	(43)	(44)	0
Net cash provided by (used in) financing activities	17,509	(16,614)	(48,957)
Effect of exchange rate changes on cash and cash equivalents	(478)	(1,231)	475
Net Decrease in Cash and Cash Equivalents	(670)	(7,565)	(20,297)
Cash and Cash Equivalents at Beginning of Year	18,409	25,974	46,271
Cash and Cash Equivalents at End of Year	17,739	18,409	25,974
Cash paid (refunds received) for:
Income taxes	16,163	(2,578)	1,230
Interest	2,659	5,478	8,564
Acquisitions:
Goodwill	30,504	10,458	0
Identifiable intangible assets acquired	7,726	1,761	170
Net tangible assets acquired	4,934	0	44
Fair value of assets acquired, net of cash received	43,164	12,219	214
Non-Cash Investing and Financing Activities
Payable for employment taxes withheld related to release of restricted stock awards	0	96	745
Accrued earn-out payments	10,346	3,700	0
Acquisition through notes payable	0	0	143
Acquisition of property and equipment through accounts payable	$ 324	$ 383	$ 555