Quarterly report pursuant to Section 13 or 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)
 3 Months Ended 6 Months Ended
Jun. 30, 2019
Jun. 30, 2018
Jun. 30, 2019
Jun. 30, 2018
Jun. 30, 2019
Jun. 30, 2018
Clinics in operation at the end of the period 468 413 468 413    
Total clinics in operation at the end of the period 468 413 468 413 468 413
Clinic licenses sold but not yet developed         176 117
Executed letters of intent for future clinic licenses         28 9
Franchised Units [Member]            
Clinics open at beginning of period 404 359 394 352    
Opened or Purchased during the period 14 8 26 15    
Acquired or sold during the period (1) (1) (1)    
Closed during the period (1) (1) (2) (1)    
Clinics in operation at the end of the period 417 365 417 365    
Total clinics in operation at the end of the period 404 359 394 352 417 365
Entity Operated Units [Member]            
Clinics open at beginning of period 50 47 48 47    
Opened or Purchased during the period 1 3    
Acquired or sold during the period 1 1 1    
Closed during the period (1)    
Clinics in operation at the end of the period 51 48 51 48    
Total clinics in operation at the end of the period 50 47 48 47 51 48