Annual report pursuant to Section 13 and 15(d)

Note 1 - Nature of Operations and Summary of Significant Accounting Policies - Clinics in Operation Under Franchise Agreements or Company-owned or Managed (Details)

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Note 1 - Nature of Operations and Summary of Significant Accounting Policies - Clinics in Operation Under Franchise Agreements or Company-owned or Managed (Details)
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2018
Dec. 31, 2017
Clinics open at beginning of period 399      
Clinics in operation at the end of the period 442 399    
Total clinics in operation at the end of the period 442 399 442 399
Clinic licenses sold but not yet developed     136 104
Executed letters of intent for future clinic licenses     19 8
Franchised Units [Member]        
Clinics open at beginning of period 352 309    
Opened or Purchased during the period 47 41    
Acquired or sold during the period (1) 6    
Closed during the period (4) (4)    
Clinics in operation at the end of the period 394 352    
Opened during the period 47 41    
Acquired during the period 1 (6)    
Closed or Sold during the period (4) (4)    
Total clinics in operation at the end of the period 352 352 394 352
Entity Operated Units [Member]        
Clinics open at beginning of period 47 61    
Opened or Purchased during the period    
Acquired or sold during the period (1)    
Closed during the period (14)    
Clinics in operation at the end of the period 48 47    
Opened during the period    
Acquired during the period 1    
Closed or Sold during the period (14)    
Total clinics in operation at the end of the period 47 47 48 47