Consolidated Statements Of Cash Flows (USD $) In Thousands, unless otherwise specified	9 Months Ended
	Sep. 30, 2012	Sep. 30, 2011
Cash flows from operating activities:
Net earnings (loss)	$ 164,249	$ 138,622
Adjustments to reconcile net earnings to net cash flows provided by operating activities:
Depreciation and amortization	22,473	18,577
Net (gain) loss on sale of long-lived assets	599	(1,280)
Share-based compensation	5,119	4,762
Excess tax benefit from share-based compensation	(1,268)	(489)
Deferred income taxes	18,617	18,584
Equity in earnings of unconsolidated affiliates, net	(1,103)	(147)
Increase (decrease) in cash and cash equivalents, net of effects of acquisitions and dispositions, due to changes in:
Accounts receivable, net	4,831	(671)
Supplies inventory	343	121
Prepaid and other current assets	(325)	1,480
Accounts payable	(2,775)	(2,370)
Accrued expenses and other liabilities	3,510	(2,661)
Other, net	1,842	1,079
Net cash flows provided by (used in) operating activities	216,112	175,607
Cash flows from investing activities:
Acquisition of interests in surgery centers and related transactions	(16,097)	(188,500)
Acquisition of property and equipment	(20,800)	(15,332)
Proceeds from sale of interests in surgery centers	0	4,574
Net cash flows provided by (used in) investing activities	(36,897)	(199,258)
Cash flows from financing activities:
Proceeds from long-term borrowings	50,211	230,525
Repayment on long-term borrowings	(111,139)	(99,543)
Distributions to noncontrolling interests	(123,066)	(103,398)
Proceeds from issuance of common stock upon exercise of stock options	11,928	4,760
Repurchase of common stock	(13,101)	(6,185)
Capital contributions and ownership transactions by noncontrolling interests	1,409	698
Excess tax benefit from share-based compensation	1,268	489
Financing cost incurred	(1,761)	(2,003)
Net cash flows provided by (used in) financing activities	(184,251)	25,343
Net increase (decrease) in cash and cash equivalents	(5,036)	1,692
Cash and cash equivalents, beginning of period	40,718	34,147
Cash and cash equivalents, end of period	$ 35,682	$ 35,839