Consolidated Statements of Operations and Comprehensive Loss (USD $) In Thousands, except Per Share data, unless otherwise specified	12 Months Ended
	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Revenues	$ 101,493	$ 102,983	$ 99,825
Operating costs and expenses
Medical professional and license fees	23,715	24,628	24,161
Direct costs of services	44,348	43,048	46,631
General and administrative	13,442	13,942	13,956
Marketing and advertising	23,055	22,678	24,114
Depreciation	4,736	5,703	9,408
Impairment charges	617	104	1,694
Restructuring charges	1,130	36	3,790
Costs and Expenses, Total	111,043	110,139	123,754
Gain on sale of assets	239	618	1,962
Operating loss	(9,311)	(6,538)	(21,967)
Net investment income and other	656	470	1,433
Loss before income taxes	(8,655)	(6,068)	(20,534)
Income tax (benefit) expense	(138)	130	43
Net loss	(8,517)	(6,198)	(20,577)
Loss per common share
Basic and Diluted	$ (0.45)	$ (0.33)	$ (1.10)
Dividends declared per share
Weighted average shares outstanding
Basic and diluted	18,982	18,811	18,680
Other comprehensive income (loss), net of tax:
Foreign currency translation	105	(90)	214
Unrealized investment (loss) gain	(11)	11	(626)
Total other comprehensive income (loss), net of tax	94	(79)	(412)
Comprehensive loss	$ (8,423)	$ (6,277)	$ (20,989)