Though Elliot boasts that through private practice she gets to get to know her patients, nobody seems to care. Carla is amazed at how the Janitor was able to score such an attractive girlfriend. The doctors are improving their services to get a higher ranking on a website and although J.D. appears nonchalant initially, he is elated when he is ranked #1.

When Dr. Kelso tells the Janitor that nobody cares what he thinks, he starts a newspaper called "The Janitorial" to prove him wrong. J.D. and Turk fight over their manhood issues, while Dr. Kelso is too proud to ask for help about one of his problems.