5. REVOLVING CREDIT FACILITY, NOTES PAYABLE AND CAPITAL LEASES (Details - Schedule of debt) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Discounts on term loans	$ (15,951)	$ (18,470)
Promissory note payable to the former owner of a practice acquired at an interest rate of 1.5% due through 2019	298	592
Equipment notes payable at interest rates ranging from 4.3% to 5.6%, due through 2020, collateralized by medical equipment	112	195
Obligations under capital leases at interest rates ranging from 3.7% to 9.3%, due through 2022, collateralized by medical and office equipment	6,420	6,538
Total debt obligations	586,340	609,127
Less: current portion	(33,376)	(34,090)
Long term portion debt obligations	552,964	575,037
First Lien Term Loans [Member]
Term loans	$ 595,461	$ 620,272

Amount equal to the present value (the principal) at the beginning of the lease term of minimum lease payments during the lease term (excluding that portion of the payments representing executory costs such as insurance, maintenance, and taxes to be paid by the lessor, together with any profit thereon) net of payments or other amounts applied to the principal through the balance sheet date.

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