Held for Sale and Discontinued Operations Additional Information (Details) $ in Thousands	3 Months Ended
Mar. 31, 2019 USD ($) clinic	Mar. 31, 2018 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Payments to Acquire Businesses, Gross	$ 11,274	$ 16,582
Series of Individually Immaterial Business Acquisitions
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Payments to Acquire Businesses, Gross	$ 10,210
Series of Individually Immaterial Business Acquisitions \| DMG held for sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of businesses acquired \| clinic	1
Payments to Acquire Businesses, Gross	$ 1,064
Business Combination, Consideration Transferred, Other	$ 105
Discontinued Operations, Held-for-sale \| DMG held for sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Contractual Termination Date	Jun. 30, 2019

Contractual Termination Date, as outlined in the Purchase and Sale Contract.

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- Definition

Amount of tangible or intangible assets, including a business or subsidiary of the acquirer transferred by the entity to the former owners of the acquiree. Excludes cash.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
-Section 50
-Paragraph 1
-Subparagraph (b)(2)
-URI http://asc.fasb.org/extlink&oid=35744584&loc=d3e6927-128479

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- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

No definition available.

+ Details

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- Definition

The number of businesses acquired by the entity during the period.

+ References

No definition available.

+ Details

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- Definition

The cash outflow associated with the acquisition of business during the period. The cash portion only of the acquisition price.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
-Section 50
-Paragraph 1
-Subparagraph (b)(1)
-URI http://asc.fasb.org/extlink&oid=35744584&loc=d3e6927-128479

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 13
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3213-108585

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