Consolidated Statements Of Cash Flows (USD $) In Thousands	9 Months Ended
	Sep. 30, 2011	Sep. 30, 2010
Cash flows from operating activities:
Net (loss) earnings	$ 138,622	$ 135,275
Adjustments to reconcile net earnings to net cash flows provided by operating activities:
Depreciation and amortization	18,661	18,498
Net (gain) loss on sale of long-lived assets	(1,280)	159
Share-based compensation	4,762	3,425
Excess tax benefit from share-based compensation	(489)	(81)
Deferred income taxes	18,584	13,417
Equity in earnings of unconsolidated affiliates, net	(147)	0
Increase (decrease) in cash and cash equivalents, net of effects of acquisitions and dispositions, due to changes in:
Accounts receivable, net	(671)	(2,953)
Supplies inventory	121	360
Prepaid and other current assets	1,480	(180)
Accounts payable	(2,370)	(2,253)
Accrued expenses and other liabilities	(2,661)	(1,948)
Other, net	995	1,037
Net cash flows provided by operating activities	175,607	164,756
Cash flows from investing activities:
Acquisition of interests in surgery centers and related transactions	(188,500)	(41,615)
Acquisition of property and equipment	(15,332)	(13,500)
Proceeds from sale of interests in surgery centers	4,574	0
Net cash flows used in investing activities	(199,258)	(55,115)
Cash flows from financing activities:
Proceeds from long-term borrowings	230,525	156,589
Repayment on long-term borrowings	(99,543)	(164,537)
Distributions to noncontrolling interests	(103,398)	(98,661)
Proceeds from issuance of common stock upon exercise of stock options	4,760	683
Repurchase of common stock	(6,185)	0
Capital contributions and ownership transactions by noncontrolling interests	698	64
Excess tax benefit from share-based compensation	489	81
Financing cost incurred	(2,003)	(4,440)
Net cash flows provided by (used in) financing activities	25,343	(110,221)
Net increase (decrease) in cash and cash equivalents	1,692	(580)
Cash and cash equivalents, beginning of period	34,147	29,377
Cash and cash equivalents, end of period	$ 35,839	$ 28,797