Note 4 - Equity Investments (Details Textual) - USD ($) $ in Thousands	12 Months Ended
Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Payments to Acquire Investments, Total		$ 1,300
PracticingExcellence.com [Member]
Payments to Acquire Investments, Total		$ 1,300
Cost Method Investment, Ownership Percentage		15.70%

The cash outflow associated with the purchase of all investments (debt, security, other) during the period.

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 13
-URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3213-108585

Name:	us-gaap_PaymentsToAcquireInvestments
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration