Addison receives a surprise visit from her brother and fellow surgeon, Archer, and his presence not only causes trouble for her, but for Naomi and Sam as well. Meanwhile Meg returns to try to make it work with Pete, and a patient accused of a malicious crime stirs up anger and emotions, for both Violet and Dell.

Charlotte's rival practice, Pacific Wellcare, opens its doors and the competition with Oceanside Wellness begins, as Sam and Pete steal one of their clients, a favorite patient of Addison's goes to a Pacific Wellcare doctor for a second opinion, and Dell proposes the creation of an in-house adoption program.