The main plot of this episode is that Dr. Maddox seems to be everywhere in Sacred Heart and is always playing by the rules and getting in the way of their ability to treat patients.  For example, J.D. and Elliot are treating a pateint, Mr. Roselle who has multiple sclerosis (MS), who they initially think is faking, but figure out it's his daughter that has it.  She's trying to get the medication using his insurance.  J.D. and Elliot are prepared to help do it but Maddox steps in and kicks them out.  Cox thinks he's outwitting Maddox and getting his patient who's 35 treated using an experimental trial only for people under 30, but when Maddox busts him he joins the gang in trying to oust Maddox.

We find out Jordan is no longer on the board but suggest that they convince Kelso to coerce the board to ousting her, he has enough dirt on everyone.  Kelso agrees to do it but only if Cox says he misses him.  Cox swallows his pride and delivers a fairly heartfelt message.  After Kelso talks to a few of the guys, Maddox gets fired and the MS patient is able to get her meds.

Meanwhile, Carla, aka the lioness this episode, is lecturing one of the interns Katie for making other students do her work and not learning it for herself.  After putting the "mini Elliot" as I like to call her in her place, she eventually comes clean.