Consolidated Statements Of Cash Flows (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2013	Mar. 31, 2012
Cash flows from operating activities:
Net earnings (loss)	$ 62,273	$ 54,939
Adjustments to reconcile net earnings to net cash flows provided by operating activities:
Depreciation and amortization	8,082	7,341
Net (gain) loss on sale of long-lived assets	0	599
Gain (loss) on deconsolidation	(2,237)	0
Share-based compensation	2,050	1,792
Excess tax benefit from share-based compensation	(288)	(79)
Deferred income taxes	12,929	8,722
Equity in earnings of unconsolidated affiliates, net	(402)	(395)
Increase (decrease) in cash and cash equivalents, net of effects of acquisitions and dispositions, due to changes in:
Accounts receivable, net	(1,705)	(1,119)
Supplies inventory	(201)	177
Prepaid and other current assets	17	(633)
Accounts payable	(3,040)	(1,693)
Accrued expenses and other liabilities	(4,101)	(985)
Other, net	488	479
Net cash flows provided by operating activities	73,865	69,145
Cash flows from investing activities:
Acquisition of interests in surgery centers and related transactions	(252)	(9,857)
Acquisition of property and equipment	(6,110)	(6,046)
Net cash flows used in investing activities	(6,362)	(15,903)
Cash flows from financing activities:
Proceeds from long-term borrowings	30,870	19,600
Repayment on long-term borrowings	(48,211)	(30,877)
Distributions to noncontrolling interests	(43,914)	(39,009)
Proceeds from issuance of common stock upon exercise of stock options	5,691	2,521
Repurchase of common stock	(16,758)	(2,823)
Capital contributions and ownership transactions by noncontrolling interests	559	869
Excess tax benefit from share-based compensation	288	79
Financing cost incurred	(13)	0
Net cash flows provided by (used in) financing activities	(71,488)	(49,640)
Net increase (decrease) in cash and cash equivalents	(3,985)	3,602
Cash and cash equivalents, beginning of period	46,398	40,718
Cash and cash equivalents, end of period	$ 42,413	$ 44,320