Advancing Cardiac Care: Insights from the Career of Dr. John Ducas
Dr. John Ducas, a cardiologist with over 40 years of experience, has been instrumental in advancing cardiovascular care through clinical innovation and leadership. In this interview, he reflects on the evolution of acute cardiac care, the value of mentorship, and lessons from a career devoted to both patient care and healthcare system improvement.
1) When you look back over 40 years in medicine, what moment or achievement makes you feel most proud?
It’s hard to pick one moment, because what I’m proudest of has been the cumulative work of many people over many years. If I had to name a few, I’m especially proud of helping centralize cardiology services at St. Boniface—building a more coherent, safer system rather than fragmented care.
I’m also deeply proud of the Manitoba ACS Network and what we’ve accomplished over the last decade: creating standardized, practical pathways that improve care for patients across the province. And finally, the northern outreach clinics—supporting First Nations and Inuit patients closer to home—have been among the most meaningful parts of my career.
2) How did your understanding of what it means to be a “good doctor” change over the course of your career?
Early in my training, being a “good doctor” meant doing everything possible for the patient in front of me—getting the diagnosis right, choosing the best treatment, being thorough, and being present.
Over time, I came to see that good medicine also means improving how care is delivered to many patients: building systems, pathways, and teams that reduce delays, reduce variation, and make good care more reliable—especially for people who live far from tertiary centres. The individual patient still comes first, but I learned that thoughtful system work is also patient care.
3) What was the most dramatic change you witnessed in ACS care during your time in practice?
The most dramatic change has been the shift from uncertainty—both about what causes STEMI and how best to treat it—to a clear understanding that acute coronary thrombosis is often the central event, and that rapid reperfusion saves myocardium and lives.
I still remember an evening session at an AHA meeting in the mid-1980s when Dr. Ganz showed coronary angiographic images of an occluded artery in STEMI, followed by intracoronary thrombolysis and restoration of flow over minutes. It was one of those “you can feel the field changing” moments. From there we moved into thrombolysis protocols, then primary PCI, better stents, better antiplatelet therapy, and—importantly—systems of care that make timely reperfusion possible for more patients.
4) Is there a patient, case, or moment that has stayed with you and continues to shape how you think about medicine?
Yes. A patient I saw in a northern community shortly after discharge from St. Boniface had been very ill with advanced heart failure and serious arrhythmia risk. When I followed up in her home community, she was doing markedly better—clinically stable, hopeful, improving.
And then she shared a devastating family loss that had occurred just as she returned home—an event that put the medical story into perspective instantly. It reminded me that health isn’t only physiology and prescriptions; it’s grief, trauma, community realities, and social conditions that can be profoundly difficult. That encounter strengthened my conviction that we need to support northern patients and communities in a sustained, practical way—not just episodically.
5) What role did teaching and mentoring play in your career, and what has it meant to watch trainees grow into colleagues?
Teaching and mentoring have been one of the great privileges of my career. It’s how you “pass the torch”—not just knowledge, but judgment: how to think under pressure, how to communicate clearly, how to put the patient first, and how to work well with nurses and allied health professionals.
Watching trainees become capable, thoughtful colleagues—and seeing them develop their own style, confidence, and leadership—has been genuinely rewarding. It’s also how the work outlives you.
Dr. John Ducas, MD, FRCPC
