Income Taxes Effective tax rate (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value of contingent earn-out	$ (4,059,000)	$ 0	$ (31,253,000)	$ 0
Effective Income Tax Rate	38.00%	18.00%	37.00%	17.00%
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent			21.00%	21.00%
Share-based Payment Arrangement, Expense, Tax Benefit	$ 1,500,000	$ 1,100,000	$ 4,100,000	$ 3.3
contingent consideration, tax expense	0		0
SmithsMedical
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value of contingent earn-out	$ (4,100,000)		$ (31,300,000)