Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Santa Barbara’s ‘Unicorn’ OB Calls It Quits title=
Dr. Melissa Drake during a public health meeting on the Zika virus in 2016 (Photo: Paul Wellman / Independent)
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This article is a joint reporting venture by Edhat and the Santa Barbara Independent and is the first in an ongoing series of stories on maternal health in Santa Barbara.


By Lauren Bray and Tyler Hayden

Dr. Melissa Drake, a highly sought after Santa Barbara OB-GYN known for her progressive approach to women’s healthcare, announced she is closing her practice at the end of the month. Drake cited personal medical issues and a desire to spend more time with her family as the reasons for decision, which came as a surprise to her many patients and created a sudden influx of demand on Santa Barbara’s remaining obstetricians.

“It has been the honor of my life to work with the women of Santa Barbara,” Drake said in her May 13 announcement on Instagram that explained her office would stop accepting CenCal insurance on June 15 before closing on June 30. “Thank you for allowing me to be part of the most personal, profound, and important days of your lives,” she said. 

A native of Tucson, Drake received her medical degree from the University of Arizona College of Medicine and completed her residency at George Washington University in Washington, DC. She opened her Santa Barbara practice in 2017 and quickly gained a local following that only grew after she delivered Meghan Markle’s daughter at Cottage Hospital last summer. Though her unabashedly patient-first attitude toward medicine endeared her to hundreds of women, it also created professional tensions with some members of Santa Barbara’s medical community, particularly around the issue of VBACs (vaginal birth after cesarean-section) and collaboration with midwives.

Sansum Clinic Medical Director Dr. Marjorie Newman said the news of Drake’s impending departure has prompted a coordinated effort “where all local obstetricians are working together to address this unforeseen challenge.” Sansum, which employs six delivering OB-GYNs on the South Coast, is “working diligently to accommodate as many patients as we can, especially those who are due to deliver within the next few months,” Newman said. Doctors have extended their hours, nurse practitioners and physician assistants from other departments have rescheduled some of their regular appointments to well-woman visits, and the clinic is actively recruiting more OBs. One is expected to start in August.

When reached by phone this Thursday, a Sansum receptionist said patients calling for an appointment are being added to a waitlist, whether they are already established with a Sansum doctor or transferring from Dr. Drake’s office. It could be “a few weeks” before they are called back, the receptionist said. Additionally, patients are currently unable to choose their doctor and will be connected with the first available physician.

The only private OB-GYN delivering in Santa Barbara, Dr. Pedram Rashti, is currently accepting pregnant patients, though Rashti’s office said they don’t have room for any women due in the next three months. After that, they had only one delivery date available for September and four for October. Attempts to speak to Rashti directly were unsuccessful. 

A call to Dr. Susan Ramos’s office revealed Ramos is not accepting pregnant patients and it’s unclear when, or if, she will in the future. Dr. Margaret Echt is no longer practicing obstetrics and is offering a concierge service for gynecological needs.[*Note: The previous sentence stated, "Dr. Margaret Echt is also no longer taking new patients and is instead offering cash-only services for other gynecological needs." This has since been updated].

The Santa Barbara Healthcare Center, as part of the county's Public Health Department, does have appointment availability but is only open to people with Medi-Cal or without insurance. Many women are now looking south for help. A receptionist at the Ventura County Obstetric + Gynecologic Medical Group confirmed they had been receiving numerous calls and transfers from the Santa Barbara area.

In addition to touching off a local scramble for replacement care, Drake’s announcement underscores an issue affecting communities across the United States ― a growing shortage of OB-GYNs. According to a 2021 study by the U.S. Department of Health and Human Services, the number of OB-GYNs is expected to decrease from 50,850 to 47,490 (7%) over the next eight years, while demand is projected to increase from 50,850 to 52,660 (4%). In 2018, California was operating with a deficit of 230 full-time OB-GYNs; it’s projected the deficit will grow to 1,160 by 2030.

Burnout is a major factor. A 2017 report by the American College of Obstetricians and Gynecologists (ACOG) states an estimated 40–75 percent of OB-GYNs experience some form of professional burnout “(e.g., losing control, conflicting demands on time, or diminishing sense of worth)” in their careers.

Layered upon the scheduling dilemmas in Santa Barbara is a palpable sense of mourning among past patients of Dr. Drake as well as hopeful mothers. “My friend group is pretty devastated to lose Dr. Drake as a practitioner in town,” said Jorden Hirsch, who said she knows at least 10 women who are now looking for new OBs. “It’s a real loss for the community.” Katherine Mueller said Drake possessed that rare dual-quality in doctors of top-level expertise paired with a compassionate bedside manner. “She always made her patients feel comfortable, in control, and always gave them the right to say no,” Mueller said.

Kay de Veer Ulanch, whose twin boys were delivered by Drake, used a word that’s frequently cited by her fans ― “unicorn.” “She puts you in charge,” Ulanch explained. “You lead your birth experience. That’s a big deal, and it’s not common.” Ulanch described the closure of Drake’s practice as a “travesty” for Santa Barbara. “I know that sounds dramatic,” she said, “but she’s done so much good to so many families. When you’re having a child, you want the best, and she’s the best.” Like others, Ulanch wonders if Drake’s decision to shut down was prompted by more than just personal reasons. “I hope we figure out what’s going on,” Ulanch said, “and I hope she comes back.” 

Anastasia Stone, a doula who worked often with Drake, said she thinks Santa Barbara’s medical establishment felt threatened by Drake, isolating her and ultimately overburdening her. “What I see is a doctor who practiced a more midwifery-focused philosophy of care, where there’s informed consent and a focus on emotional outcomes,” Stone said, explaining she is personally aware of other OB-GYNs performing procedures and administering medications without a patient’s permission. 

“So you have this stark contrast in the way care is being provided, and it puts pressure on other doctors to change how they’re practicing,” Stone went on. That dynamic bred resentment, she claimed, and led to Drake being ostracized by many of her colleagues. A Santa Barbara nurse, who wished to remain anonymous, agreed with Stone’s assessment. “Maternal healthcare in S.B. is extremely lacking,” the nurse said. “This is much of the reason so many people flooded to Dr. Drake. She gave the personalized, evidence-based care that is not present with many of the other practitioners in town.”

Drake herself declined to expand on her reasons for closing or address rumors of an eventual return, but she did offer more insight into her philosophies on maternal health and the time-consuming nature of her approach. “One of my most important guiding principles is patient autonomy and giving power back to women,” she said in a statement provided Tuesday. “OB/GYN care represents an inflection point in peoples’ lives. People who feel disempowered and disrespected during their birth experience carry that with them forever. It impacts not only the way they feel as parents, but also impacts their future interactions with healthcare.”

Women are socialized to avoid conflict, Drake went on, which can spill over into the doctor-patient relationship. “Ask any woman about their medical experience, and you will hear a lot about soft pressure,” she said. “I try to let patients know that even if they are making a decision that I don’t agree with, I will try to support them as best I can, within my ability to do so.”

Why is this such a rare thing? Drake asked. Why is she called a unicorn? “Because it is very labor intensive,” she said, further explaining that it takes time to have these conversations. “The healthcare system is not set up to reimburse providers for this kind of work… But we deserve this kind of care. We all do.”


[Update 6/17/22: The Santa Barbara community of obstetricians provided a response to the above article. It can be read in full here.]

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Lucky 777 Jun 16, 2022 08:32 AM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Such a sad trend, the state of health care in America is declining and with it faith in doctors. I recently tried to switch my primary care doctor at Sansum to a new one, who is listed as accepting new patients, and was told the next available appointment with him is in August 2023. The new focus on telehealth and urgent care clinics lessens the traditional doctor-patient relationship of trust and respect.

a-1655394156 Jun 16, 2022 08:42 AM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Some really alarming stuff in this article about healthcare here.

"other OB-GYNs performing procedures and administering medications without a patient’s permission." Very illegal.

"professional tensions with some members of Santa Barbara’s medical community, particularly around the issue of VBACs (vaginal birth after cesarean-section) and collaboration with midwives." Why the heck do other doctors care? Seems bullying

AwareHuman Jun 16, 2022 09:07 AM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Indeed, health Care is mediocre in SB, at best. A doctor who cares & spends time with patients is not supported. My friend is an internist & is constantly told NOT to spend more time w/ patients...even threatened with a "fine" to do so. It's all about money, money, money. Pity the doctor who cares!

beasmart Jun 16, 2022 09:44 AM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

This is a very well written and researched article - congratulations! - but a sad expose of the trend in healthcare. It's too bad Dr. Drake wasn't able to effect more widespread change - it must have been a very difficult decision for her to leave. Thank you EdHat for bringing this to our attention!

Drea Jun 17, 2022 10:37 AM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Dr Drake abandoned her obstetrics patients. That is one of the worst things a physician can do. I have not witnessed another OBGYN doing this ever. Every other OB in SB is overloaded and hammered in helping out by taking as many of her obstetrics patients as humanly possible and instead of then getting thanked- they are getting shamed! Dr Drake quit. She walked out. This article is not well written and it is false. I look forward to the truth.

a-1655490281 Jun 17, 2022 11:24 AM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

She gave nearly 2 months notice, seems like ample time, no? The bigger issue here is why aren't there enough OBgyns? Why is everyone so overworked and unable to handle the patient load that they already have?

Drea, you seem to have some kind of personal experience here and are rather defensive. Perhaps another question is why did so many women choose her? Are you saying their experiences and opinions are false?

Drea Jun 17, 2022 12:09 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

An OBGYN closing their practice sees the last obstetrics patient through to delivery. They stop taking new patients, announce their closure and physically stop when the last patient has delivered. This is common practice in medical ethics. Two months is very little time when pregnancy is 9-10 months and our care load is over stretched. The question of why are we over stretched is an American Health Care Crisis. The cost of living (housing) in SB is prohibitive for many new physicians to move here. An established physician won’t likely close shop and move to a new town- all their patients, their practice. When doctors put down roots it is usually for their entire career. OBGYN keep retiring. It is a job that requires almost 24/7 365 attention. Babies come at any hour and any day. It’s exhausting work. Liability is also almost prohibitive. And medical reimbursement continues to dwindle. If you’re not in health care yourself perhaps these very obvious problems are not known. In other words- it’s going to get worse.

Mebk Jun 16, 2022 09:58 AM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

I fear this will become a way to familiar story. My Dr. Told me he will not be able to stay in business much longer if he wants to continue treating his patients the way he has for the last 45 years. Government is trying to tell them how to treat their patients. Do it our way or you can not get reimbursed from Medicare. There is way too much Medicare fraud going on and it gonna get worse. I too tried to get a appointment with a ob/gyn for a issue I was having 6 months lol so now go to emergency room run 100 tests then be told to follow up with a dr you can’t see for weeks or even months.

Voice of Reason Jun 16, 2022 11:19 AM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

I have a lot of issues with government inserting themselves into the doctor / patient relationship but I don't want to trigger any of the regulars so I'll leave it and that and this link if you'd like to read more about how much the government has intruded into that relationship. Like all articles, the author has a clear bias but that doesn't mean his points are invalid. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9062939/

roadrunner Jun 16, 2022 10:45 AM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

I’ve had all my children through Sansum Clinic and just wanted to say that the OB/GYNS and support staff are some of the most caring and hardworking people I’ve ever dealt with and shout out to everybody who works in Labor & Delivery at Cottage. I know there are many out there who agree with me. I was happy they were there with me when obviously everything doesn’t go as planned during your pregnancies and there are last minute, scary, decisions being made during your course of labor by professionals who know a lot more about delivering a healthy baby than I do. Sadly, two OB practices in town have shut down in the last 6 months leaving all these pregnant women to have to find a new provider when the existing providers have been struggling to keep up with the volume as it is. My heart breaks for them. Honestly, we should be thanking all the doctors and nurses in town for keeping up with their volume of patients, especially in the never ending time of covid. If you have the time a nice letter to one of your providers would probably mean a lot to them instead of articles like this that seem to make outlandish, libelous, accusations about medical professionals.
 

notme Jun 16, 2022 01:03 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Agree. I loved my Sansum OB/GYN and was so sad when he retired. I saw him for 30+ years and he always was friendly, thorough, and went out of his way to make me feel comfortable. I was thrilled when I found out he was the doctor-on-call the night I went into labor, so he delivered my child.

a-1655410071 Jun 16, 2022 01:07 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

It's great that you had a good experience at Sansum and Cottage. My wife did too. But we also have several friends who did not. Birth experiences vary but standard of care should not.

roadrunner Jun 16, 2022 01:56 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

i was referring to Ms. Stone's accusations: Stone said, explaining she is personally aware of other OB-GYNs performing procedures and administering medications without a patient’s permission.

Sbladyres Jun 16, 2022 12:21 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Edhat, you guys really missed the mark on this one. Your duty as journalists is to investigate and you have failed to uncover the truth behind her decision to close her practice. Instead, you have glorified her without doing the real homework.

Chevy67 Jun 16, 2022 01:03 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

The only person who can speak to why she closed is Dr. Drake herself, and she said health reasons. I doubt any Dr in town would be quoted on their opinions of another dr, too small and fear of retribution. If you have some clear evidence then send it to the writers, I'm sure they'd love to see it.

a-1655410395 Jun 16, 2022 01:13 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Seems like there is a lot of drama with the doctors or hospital or whoever. But is it considered "glorifying" if the patients are the ones doing the glorifying? They're really just reporting what people are saying. All of my friends had nothing but positive stuff to say. Sure there's always patients that don't agree but that's the norm for any business or professional. Hard to get that 5/5 star on Facebook.

Uncommon sense Jun 16, 2022 01:12 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

This is a big loss to the community. After a really bad experience with Sansum and Cottage (one I found out later wasn't totally unheard of) I found Dr. Drake, and it truly changed my experience and opened my eyes. There is a lack of good care is town and it is very unfortunate. Dr. Drake was the best!

sbmom4444 Jun 16, 2022 01:25 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

There is definitely more to the story and without much effort, I am sure Edhat and the Independent could have found patients willing to speak to (perhaps anonymously) different perspectives on their experience with Dr. Drake and her practice. As a former patient, I switched to a different OB for my 6-week post-birth checkup because the idea of walking into her office again was too traumatizing. From my experience, she is a skilled and kind physician but it seems that her practice just got completely out of control and the level of care patients received was subpar, at best. This article does not discuss any of the mayhem that occurred in her office before she closed it down, including randomly hiring another OB-GYN from out of town to assist but not announcing that hire to any patients so that patients went to their appointment expecting to see Dr. Drake only to have a complete (and unexplained) stranger walk into the room to perform invasive procedures/checks. Completely unacceptable.

bornatcottageho... Jun 16, 2022 01:28 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Truly truly unfortunate. I can attest to the validity regarding statements suggesting doctors don't work together in this field in SB. In 2014, a close personal friend lost her baby at the hands of the Santa Barbara Birth Center days before she was due leading to a Stillbirth. Dr. Ramos wouldn't touch her because of her affiliation with the birth center when she sought further help or diagnosis-there was absolutely no 'working together'. Shouldn't all doctors see to the health and safe delivery of any child? The result was horrific at best and the only somewhat bright spot was when she was admitted to cottage to deliver. They did what they could and were as caring as could be given the situation but the Birth Center failed and the reluctance of Ramos was appalling.

a-1655413478 Jun 16, 2022 02:04 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Seems like that bullying claim could be true. Women are going to hire doulas and midwives, and do home births, and go to the birth center. Doctors should be there to support them, not isolate them.

laurelphillips Jun 17, 2022 03:01 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Unfortunately there are very rare situations where a term baby will become tightly entangled in its cord in a way that stops blood flow, resulting in death before labor begins. This has happened once in the eleven year history of the SB Birth Center. Any obstetrician or midwife who practices long enough will encounter this very sad situation. Unfortunately there is nothing to do to prevent it.
We understand the helplessness everyone involved feels and that it can feel easier to blame.

bornatcottageho... Jun 17, 2022 08:04 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

So, here is Laurel Phillips, the founder or the Santa Barbara Birth Center suggesting that a tragedy of epic proportions that was stated above is casting blame? The facts of the matter are just that, they are facts. I see no blame in the commentary and statement of facts. Those are what happened and you know that to be true. You want to reduce that to blame? Shame on you Laurel.

bornatcottageho... Jun 17, 2022 08:24 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Will add that Laurel and her (not) amazing facility were paid in full for there service and that the support post event were similar to her statement above-taking zero responsibility and running in the opposite direction as fast as they could and BLAMING the patient.

bornatcottageho... Jun 17, 2022 08:40 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Laurel Phillips: Was the birth center paid to deliver a baby? Yes. Was anyone from the birth center present for the birth? No. That being said, what would compel you to divulge, in graphic detail the event that transpired? You weren't there and none of your staff were there, correct? How are you privy to that very detailed information you just spat out into the universe? You ran away from this, right? You left it to true professionals to clean this up yet still demanded payment. That is what happened, nothing more, nothing less.

Sunlover Jun 16, 2022 01:56 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

It's good to see this article and learn a little about what happened after hearing about Dr. Drake, who I know was deeply appreciated by her patients. Healthcare is in serious trouble all over, not just Santa Barbara. I live in Santa Barbara now but moved recently from L.A. where it is equally as difficult to find good medical care. I'm afraid it is going to get much worse before it gets better.

roadrunner Jun 16, 2022 01:59 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

As far as the libelous accusations, I was referring to Ms. Stone: Stone said, explaining she is personally aware of other OB-GYNs performing procedures and administering medications without a patient’s permission. And yes I agree the author could've done a better job on finding out why she in fact closed her practice. Or maybe how about interviewing another OB/GYN in town instead of playing gotcha w/the receptionists at all the local offices.

a-1655413367 Jun 16, 2022 02:02 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

But Sansum Clinic did respond for their practice, and the 6 doctors they house. Again, how do you discover something when the dr says health reasons? If you know more, say it.

RE: Stone, How is it libel if no one is specifically named? If someone states their experience, how is it untrue? I know I've been in the hospital and more than I can count I had to ask what drug was being given to me, what is it for, etc. etc.

Drea Jun 16, 2022 02:47 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

This article is grossly untrue and one sided. Thank you National Inquirer. On the topic of libel- specific offices have been named. Doctors have been named. Accusations of misguided treatments and procedures have been stated. A specific patient has been announced breaking HIPPA which is illegal- unless the dutchess gave the author permission to disclose her care…. And I highly doubt that. That’s not a unicorn, it’s a devil horn and this article is false. I would expect better due diligence to have been done. Enjoy the legal fees.

a-1655416925 Jun 16, 2022 03:02 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

What part is one sided? And what part is libel? No specific dr was mentioned about doing x, y, or z. Just a vague reference. Also, if you google Drake and Markle, numerous publications have published this info, including Vanity Fair.

Chevy67 Jun 16, 2022 03:03 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

What's untrue? Seems a lot of people of "insider knowledge" but aren't saying anything. If something is false, spread the truth since you all seem to know it.

Drea Jun 16, 2022 03:18 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Dr Ramos does take new patients with her NP. She took on as many patients of Drake’s OB as humanly possible.

Drake an OBGYN has a moral obligation to her obstetric patients to see them through to delivery. Quiting them was a travesty.

Deeming her a unicorn doctor was in interviews with her friends and her personal staff. That is one sided.

Stating that other doctors perform unnecessary procedures is a blatant lie and plants a seed that Drake is a victim. Untrue.

Drake was not the over seeing MD on the dutchess. She was called in last minute and she signed non disclosure paper work which apparently has been broken.

a-1655418773 Jun 16, 2022 03:32 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

"The Duchess of Sussex’s care at the facility was overseen by Dr. Melissa Drake with remote guidance from Dr. Gowri Motha in the U.K. who helped deliver her first child, Archie, at Portland Hospital in London."
Source: Vanity Fair
https://www.vanityfair.com/style/2021/06/meghan-markle-birth-plan-lilibet-security-team-give-birth-in-peace-prince-harry

letmego Jun 17, 2022 09:10 AM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

DREA, I don't have a dog in this fight (I'm old, my babies were delivered by Sansum doctors). From what I've read and heard from my younger friends, Dr. Drake was VERY MUCH beloved by the vast majority of her patients. Thus, the description of "unicorn" is hardly one-sided because patients are not personal staff or friends.

Also, being old and having dozens or more friends who gave birth before Dr. Drake was even a doctor, I can say for SURE that my friends have complained of unnecessary procedures performed by other doctors (without consent).

Natty Jun 17, 2022 02:41 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Drea, this is so not true. I called Ramos’ office trying to make an appointment and was basically hung up on by a rude office staff member saying she is not taking any new patients.

Shame on you or anybody who bashes dr drake for taking care of herself, if that means closing her office that is her right to do so. As a patient of Dr. Drakes, she went over and beyond, advocated for me every step of the way with my last two pregnancies. I had a traumatic experience with a local doctor in town with my first pregnancy. Dr. Drake is the best, hence why we are all devastated to see her go. It took me years to find her and I know nobody else compares to her in town. She’s amazing and everyone who had the privilege of being under her care feels that way. I wish the best for her and I hope she comes back in the future. She went over and beyond for us all and I know she’ll make another huge positive impact with whatever her next chapter is.

Drea Jun 17, 2022 03:33 PM
Santa Barbara’s ‘Unicorn’ OB Calls It Quits

Natty,

If you are willing to see an NP - Dr Ramos does take new patients with the NP. Otherwise one person simply cannot take on the lot of another physicians practice. I’m glad you had a nice experience with Dr Drake. I stand by that an OBGYN sees their patients through.

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