Consolidated Statements Of Cash Flows (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Cash flows from operating activities:
Net earnings (loss)	$ 261,544	$ 223,643	$ 190,114
Adjustments to reconcile net earnings to net cash flows provided by operating activities:
Depreciation and amortization	33,028	29,850	25,645
Net (gain) loss on sale of long-lived assets	(1,468)	(1,065)	(1,518)
(Gain) loss on deconsolidation	(2,237)	0	0
Share-based compensation	8,321	6,692	6,178
Excess tax benefit from share-based compensation	(7,247)	(1,784)	(977)
Deferred income taxes	38,363	24,558	23,623
Equity in earnings of unconsolidated affiliates, net	(3,151)	(1,564)	(613)
Increase (decrease) in cash and cash equivalents, net of effects of acquisitions and dispositions, due to changes in:
Accounts receivable, net	(1,297)	8,061	(2,122)
Supplies inventory	132	110	168
Prepaid and other current assets	(5,308)	(4,651)	838
Accounts payable	441	579	(2,205)
Accrued expenses and other liabilities	6,693	7,550	2,329
Other, net	5,010	3,673	1,963
Net cash flows provided by operating activities	332,824	295,652	243,423
Cash flows from investing activities:
Acquisition of interests in surgery centers and related transactions	(73,594)	(277,388)	(239,223)
Acquisition of property and equipment	(28,856)	(28,864)	(22,170)
Proceeds from sale of interests in surgery centers	3,553	7,309	7,026
Other	159	0	0
Net cash flows used in investing activities	(98,738)	(298,943)	(254,367)
Cash flows from financing activities:
Proceeds from long-term borrowings	162,204	565,566	288,869
Repayment on long-term borrowings	(202,083)	(394,164)	(129,107)
Distributions to noncontrolling interests	(184,149)	(162,941)	(138,724)
Proceeds from issuance of common stock upon exercise of stock options	33,349	18,214	6,872
Repurchase of common stock	(45,964)	(13,101)	(10,007)
Capital contributions and ownership transactions by noncontrolling interests	1,074	1,595	660
Excess tax benefit from share-based compensation	7,247	1,784	977
Financing cost incurred	(1,322)	(7,982)	(2,025)
Net cash flows provided by (used in) financing activities	(229,644)	8,971	17,515
Net increase in cash and cash equivalents	4,442	5,680	6,571
Cash and cash equivalents, beginning of year	46,398	40,718	34,147
Cash and cash equivalents, end of year	$ 50,840	$ 46,398	$ 40,718