It is believed the healthcare industry in general is experiencing an increasing trend toward outpatient treatment rather than traditional inpatient treatment. Additionally, healthcare reform efforts in recent years have placed an increasing emphasis on reducing the time patients spend in hospitals. Finally, today’s office-based physicians have far fewer office hours readily available to patients, especially on short notice. Between 1999 and 2003, the number of patient visits per hospital emergency department increased 10.8%. This increase in ED visits, combined with the fact that approximately 40% of all hospital inpatient admissions originate in the emergency department, represents a significant contributing factor to the outsourcing of emergency departments since inpatient satisfaction is strongly tied to the patient’s initial treatment in the emergency department.

The market for outsourced services tends to be highly fragmented. However, local providers often lack the operating capital, experience, breadth of services and sophisticated information systems necessary to meet the increasingly complex needs of hospitals. As a result, healthcare facilities seek third-party physician staffing and administrative service providers that can not only improve department productivity and patient satisfaction while reducing overall costs, but also offer a breadth of staffing and management services, billing and reimbursement expertise, a reputation for regulatory compliance, financial stability and a demonstrated ability to recruit and retain qualified physicians, technicians and nurses. In particular, emergency departments face significant challenges with respect to capturing patient billing data and billing and collecting a high volume of relatively small dollar amounts. As a result, they seek third-party providers with the billing expertise, IT infrastructure and systems necessary to reduce their administrative burden and complexity.

The Company is the largest provider of outsourced physician staffing and administrative services for hospital emergency departments in the United States, based upon revenues and patient visits. The Company contracts with the hospitals to provide qualified emergency physicians and other healthcare providers for their emergency departments. In addition to the core services of contract management, recruiting, credentials coordination, staffing and scheduling, the Company provides its client hospitals with enhanced services designed to improve the efficiency and effectiveness of the emergency department.

The Company also provides physician staffing and administrative functions for inpatient services, which include hospitalist, intensivist, and house coverage services.

The Company provides outsourced radiology physician staffing and administrative services in the U.S., both on a fee-for-service basis and a cost-plus basis. The Company contracts directly with radiologists to provide radiology physician staffing and administrative services.

The Company provides a wide range of management services to anesthesia practices on a fee basis, including strategic management, management information systems, third-party payer contracting, financial and accounting support, benefits administration and risk management, scheduling support, operations management and quality improvement services using proprietary anesthesia management practice software. The Company also arranges for the provision of billing and other management services on a management fee basis to anesthesia practices.

The Company provides outsourced pediatric physician staffing and administrative services for general and pediatric hospitals. These services include pediatric emergency medicine and radiology, neonatal intensive care, pediatric intensive care, urgent care centers, primary care centers, observation units and inpatient services. The Company also operates seven after-hours pediatric urgent care centers in Florida.

Professional service expenses totaled $366.6 million in the six months ended June 30, 2005 compared to $385.9 million in the six months ended June 30, 2004, a decrease of $19.3 million or 5.0%.

Gross profit was $123.3 million in the six months ended June 30, 2005 compared to $101.6 million in the six months ended June 30, 2004 for an increase of $21.7 million between periods.

Net interest expense decreased $0.4 million to $13.9 million in the six months ended June 30, 2005, compared to $14.3 million in the six months ended June 30, 2004.

Net earnings were $30.1 million for the six months ended June 30, 2005 compared to a net loss of $56.0 million for the six months ended June 30, 2004.