During Season 2, Ray, Doug's father, tries to reconcile with his estranged son. Doug has difficulty reconnecting with the man who abandoned him and his mom. Ray has made something of himself by owning a very ritzy hotel in Chicago, and Doug lets his guard down a little, but is disappointed yet again when his father offers to take him to a Bulls game and then stands him up. Doug later has an affair with Ray's girlfriend, a woman who Ray stole money from, but ends the relationship when it becomes clear she has a lot of problems herself. Doug gets a phone call one day informing him of his father's passing, and that someone would need to pick up the remains. He goes to California on a road trip with Dr. Mark Greene to collect his remains. Ross finds out that his father was killed in an automobile accident; he had been drunk at the wheel and killed the other driver, himself and his new wife. Doug visits the funeral ceremony to express his sorrow to the victim's family, but ultimately does not and tells the priest overseeing the ceremony that his father was responsible, who then reassures Doug that he truly loved his father. When Doug and Mark find the hotel his father stayed in, he finds his father's car and belongings. They discover home videos that Ray had taken of Doug and his mother. Later on, Doug finds his old flame, nurse Carol Hathaway, waiting for him and they kiss passionately.

Doug is a womanizer, who has dated and left many women throughout the course of the show; in the first season, it is mentioned that Doug has an eight-year-old son whom he has never met, but nothing further is ever revealed. Doug's womanizing days come to an abrupt end when he had a one night stand with an epileptic woman who hides her condition and ends up in the ER and then dies after which Doug remains single until he gets back together with Carol. Doug has an on-again, off-again relationship with Carol Hathaway, the head nurse of the ER at County. He pursued her constantly when she was trying to move on with her life after their horrible break-up. After a while, they become a couple and are even engaged. They seem happy, and were also supporting each other in the ER. Doug was always an advocate for his patients, and often broke the rules to help them. Eventually, his attempts to help his patients went too far - leading to reprisals and the closure of Hathaway's clinic - and he decided to leave Chicago for Seattle at the end of Season 5. Carol decided not to go with him to Seattle, but he shared a drink with his best friend, Dr. Mark Greene, before he leaves. Carol is pregnant with his twin girls, named Tess and Kate, and these daughters are born after Doug leaves. He's last seen in the Season 6 episode "Such Sweet Sorrow", in which Hathaway leaves Chicago to reunite with him. She finds him working on his boat behind his house in Washington and the two embrace and kiss. It is later revealed in Season 8 that Hathaway sent for the twins the next day and has been living with Ross in Seattle since. Warner Brothers, the studio which produces ER for NBC, kept Dr. Ross' cameo in "Such Sweet Sorrow" a secret from NBC, which promoted the episode as Carol Hathaway's goodbye, with no mention of Dr. Ross' appearance. In fact, the original version of "Such Sweet Sorrow" that Warner Brothers sent to NBC ended right after the scene where we see Hathaway on the plane to Seattle. At the 11th hour Warner Brothers messengered an "edited" version of the episode to NBC headquarters in New York for broadcast — NBC had no time to preview the episode prior to airing what turned out to be an extended episode in which Clooney appears. NBC was miffed that it was kept in the dark as it lost valuable ad revenue it could have generated if it had aired promos that the episode would mark the return of George Clooney. Clooney cited the fans of the show for his reason as to why he agreed to make the cameo (he wanted Hathaway and Ross' characters to get back together, as most fans always had hoped for). Clooney reportedly only asked to be paid scale for the cameo. The portion of the episode with Clooney was filmed on location at the Perfect Storm set which Clooney was filming at the time.

In the 11th season finale "The Show Must Go On" Dr. Ross was briefly shown in a photograph that was part of a slideshow at Dr. John Carter's farewell party.

In the season 14 episode, "Status Quo", Jeanie Boulet mentions Doug and Carol when she returns to the ER. Nurse Haleh Adams states that they are living happily in Seattle and that their daughters are now in 3rd grade.

Later in the first season, Carol gets engaged to John "Tag" Tagilieri, an orthopedic surgeon, (played by Rick Rossovich) and despite Doug making a deliberate attempt to persuade her out of marrying him, Carol decides to go through with the wedding. However, right before they are about to walk down the aisle, Tag informs Carol that he knows she could never love him the way he loves her and decides he can't go through with the wedding. He leaves Carol to explain the situation to their many guests. Prior to this, Carol attempted to adopt an abandoned Russian girl, who was suffering from AIDS. However, after a background check showed her suicide attempt only months earlier, her application was rejected.

Carol began Season Two by purchasing a run-down, rickety house. She later becomes involved with a paramedic, Ray "Shep" Shepard (played by Ron Eldard), who moves in with her and helps her renovate her house. However, despite a promising start, their relationship is severely strained after Shep undergoes a drastic personality change brought on by the death of his work partner. Shep and his partner had decided to enter a burning building to save children who were trapped by the fire. Shep's partner was badly burned and he later died in the ICU. Shep becomes abrasive, and despite Carol's attempts to get him professional help to deal with his anger, he refuses. Although Carol loves Shep, she decides that she can't watch him self-destruct, so she ends their relationship.

In Season Three, Carol suffers severe financial problems, as without Shep's extra income she is unable to afford her house. Things get even worse when a labor dispute arises concerning the re-assignment of her staff nurses. As Nurse Manager for the ER, Carol is privy to management decisions, and she finds herself torn between her friends and hospital administration. During a nurse sickout, Carol accidentally transfuses the wrong blood into a patient, and although it is unclear whether the blood causes his death, or if he dies from his other injuries, Carol puts the blame on herself. Carol is initially not punished for this incident, which the administration uses to cast the sickout in a bad light. Because she resents the administration's actions and because she believes she is not being punished sufficiently for her error, Carol goes to the press and is suspended.

During her suspension, Carol is held hostage at gun point, when her local grocery store becomes victim to an armed robbery. Her medical knowledge proves invaluable when several people are injured and she manages to escape the incident shaken, but unharmed. Carol later takes her MCAT exams to see if she is capable of becoming a doctor. She is helped by Doug and although she assumes she failed, she passes with flying colors (although she opts not to progress any further as she had only taken the exams to find out if she was capable). During the last few episodes of Season Three, Carol and Doug become closer and eventually rekindle their relationship.

Their relationship is held up by Carol's insecurities, but soon they make it work. They are trying for a baby when Doug leaves Chicago in the middle of Season 5. (He had been strongly advised to relocate after allegedly teaching a mother how to bypass an automatic pain-medication release device to deliver a lethal dose to her terminally-ill child.) Unbeknownst to him, he leaves Carol pregnant. Carol delivers twins Tess and Kate at Thanksgiving in Season 6. When Doug learns of the twins' birth, he invites them to come to live with him in Seattle state, but Carol cannot decide if it is the right thing to do and attempts to raise their twins alone. She also briefly dates Kovac. After treating a woman dying of end-stage ovarian cancer and helping her family say goodbye, Carol is moved to reunite her own family. She abruptly leaves work and flies to Seattle that day to reunite with him in the second-to-last episode of Season 6. It is later revealed that Carol sent for her daughters the next day and stayed with Doug.

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