Investments in Unconsolidated Affliliates (Details) (USD $)	3 Months Ended		9 Months Ended			9 Months Ended						9 Months Ended			3 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013	Dec. 31, 2013	Sep. 30, 2014 Ambulatory Services [Member]	Sep. 30, 2013 Ambulatory Services [Member]	Sep. 30, 2014 Ambulatory Services [Member] Joint Venture [Member]	Sep. 30, 2013 Ambulatory Services [Member] Joint Venture [Member]	Sep. 30, 2014 Ambulatory Services [Member] Controlling Interest [Member] Joint Venture [Member] center	Sep. 30, 2013 Ambulatory Services [Member] Controlling Interest [Member] Joint Venture [Member] center	Sep. 30, 2014 Ambulatory Services [Member] Noncontrolling Interest In Centers [Member] Joint Venture [Member] entity	Sep. 30, 2014 Ambulatory Services [Member] Minimum [Member]	Sep. 30, 2014 Ambulatory Services [Member] Maximum [Member]	Sep. 30, 2014 Physician Services [Member] Joint Venture [Member]	Jul. 16, 2014 Physician Services [Member] Joint Venture [Member]	Sep. 30, 2014 Physician Services [Member] Other Current Assets [Member] Joint Venture [Member]
Schedule of Equity Method Investments [Line Items]
Number consolidated centers contributed to joint venture										4	1
Proceeds from divestiture of interest in consolidated subsidiaries								$ 1,700,000
Number of joint venture entities acquired												3
Payments to acquire noncontrolling interest in jointly owned entity								500,000
Acquisitions and related expenses, net			2,138,648,000	59,455,000		24,400,000	59,500,000		300,000
Investments in unconsolidated affiliates	73,126,000		73,126,000		15,526,000			7,000,000	5,200,000
Equity in earnings of unconsolidated affiliates	2,158,000	1,095,000	3,461,000	2,193,000				2,100,000	2,200,000						1,400,000
Estimated probability of fair value variables range													5.00%	35.00%
Gain on deconsolidation	0	0	3,411,000	2,237,000
Fair value of investment																49,100,000
Ownership percentage																51.00%
Management and billing fees															2,200,000
Receivable from entity																	$ 4,300,000