Knock Knock, Hi! with the Glaucomfleckens

Knock Knock, Hi! with the Glaucomfleckens

"Knock Knock, Hi! with the Glaucomfleckens" dives into the highs, lows, and WTFs of healthcare. Whether you're in the medical field, live with a healthcare worker, or broke your arm once and are still paying off your medical bills, this is a must-listen. Join Will and Kristin Flanary (aka the Glaucomfleckens) for candid chats with leading healthcare voices like Dr. Mike and Surgeon General Dr. Vivek Murthy. Discover fun facts about eyeballs, hear relatable stories from medical training, and sneak a peek into the U.S. health insurance industry (spoiler alert: it's not great!). We'll share our own perspectives of being a patient or family member experiencing the healthcare system. And, of course, we explore the question on everyone's minds: "Why has Dr. Glaucomflecken never had his eyes dilated?" Combining science with humor and a dash of snark, we unpack the human side of healthcare.

  1. قبل ١٦ ساعة

    Knock Knock Eye: Top 5 Most Impractical Glasses in Pop Culture History

    In this episode of Knock Knock Eye, I share my picks for the top 5 most impractical glasses in pop culture history, from Morpheus’s infamous clip-ons to Scrooge McDuck’s precarious specs. I also reflects on the continued use of virtual residency interviews in 2024, weighing their pros and cons for applicants, and gives a shout-out to the lively fans in Pittsburgh after a memorable live show. Wrapping up, I address insightful comments on pediatric eye health from listeners. Join me for a fun, eye-opening discussion on eyewear in film, medical training, and more. Takeaways: The Continued Shift to Virtual Residency Interviews: Dr. Flannery explores why many residency programs have stuck with virtual interviews post-pandemic, weighing the financial and logistical benefits for applicants. Cost Savings for Applicants: Virtual interviews alleviate the significant financial burden of in-person interviews, which often require flights, hotels, and transportation, saving applicants thousands of dollars. The Drawbacks of Going Virtual: While virtual interviews offer convenience, Dr. Flannery acknowledges the challenges applicants face in gauging a program’s culture and the city’s lifestyle without visiting in person. Top Impractical Movie Glasses: From Morpheus’s clip-on glasses to Scrooge McDuck’s floating specs, Dr. Flannery shares his picks for the five most impractical eyewear choices in cinema. Pediatric Eye Health Insights: Responding to viewer comments, Dr. Flannery discusses signs of eye problems in children, such as head tilting and eye covering, and emphasizes the importance of early screenings. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you like the scrubs I'm wearing, here's a link and discount code to get some Jaanuu Scrubs link: https://bit.ly/4cAvXbs code: DRG20 for 20% off first-time purchases* *This code works on full-price items only excluding embroidery!  If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 Today's episode is brought to you by the Nuance Dragon Ambient Experience (DAX). It's like having a virtual Jonathan in your pocket. If you would like to learn more about DAX Copilot check out http://nuance.com/discoverDAX and ask your provider for the DAX Copilot experience. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

    ٤٣ من الدقائق
  2. قبل يومين

    Women Surgeons, Toxicity in the Medical Field, and the 80 hour Work Week

    Dr. Betsy Grunch (@ladyspinedoc) joins this episode of Knock Knock Hi with Dr. Glaucomflecken and Lady Glaucomflecken. Dr. Betsy Grunch shares her experience as an orthopedic spine surgeon and being a part of such a small network of women surgeons across the world. Listen to this episode for conversation on work-life balance [00:40:00], breaking stereotypes [00:28:00], increasing representation of women surgeons [00:29:00], and sharing solutions for overcoming toxicity in the medical field [00:31:00]. This episode reminds us that humanity in medicine can even start with patients letting their doctors take a nap before surgery! [00:42:00] Connect with Dr. Betsy Grunch: YouTube https://www.youtube.com/@ladyspinedoc TikTok tiktok.com/@ladyspinedoc X (formerly Twitter) twitter.com/ladyspinedoc Instagram instagram.com/ladyspinedoc Connect with Dr. Glaucomflecken and Lady Glaucomflecken: Glauc to Me newsletter glaucomflecken.com/newsletter Get Tickets to Our Show glaucomflecken.com/live If you like the scrubs I'm wearing, here's a link and discount code to get some Jaanuu Scrubs link: https://bit.ly/4cAvXbs code: DRG20 for 20% off first-time purchases* *This code works on full-price items only excluding embroidery! If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact. For more information go to Anatomy Warehouse DOT com. Link: Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit http://www.EyelidCheck.com for more information. Today's episode is brought to you by the Nuance Dragon Ambient Experience (DAX). It's like having a virtual Jonathan in your pocket. If you would like to learn more about DAX Copilot check out http://nuance.com/discoverDAX and ask your provider for the DAX Copilot experience. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

    ١ س ٨ د
  3. ٢١ ربيع الآخر

    Knock Knock Eye: How Hurricane Helene Caused A Nationwide IV Fluid Shortage

    In this episode of Knock Knock Eye, I dive into the complex world of cataract surgery, sharing an extraordinary case of a patient who had gone 15 years without cataract surgery after a vitrectomy. I reflect on the difficulties of operating on a dense, hardened cataract, discussing the intricacies of such procedures and how prior surgeries can accelerate cataract progression. Additionally, I discuss the current IV fluid shortage caused by Hurricane Helene, which damaged a major production facility in North Carolina. This shortage is impacting hospitals nationwide, affecting elective surgeries and patient care. With a mix of surgical insights, healthcare challenges, and humorous personal stories, this episode offers a captivating look at life in medicine. Takeaways: Cataracts Can Worsen After Eye Surgery: Dr. Flannery explains how cataracts progress faster in patients who have undergone a vitrectomy, emphasizing the importance of timely cataract surgery to avoid complications. Challenges of Dense Cataracts: In this episode, Dr. Flannery shares his experience with a particularly dense cataract, describing the advanced techniques required to remove it and the complexities involved when the eye’s lens is unstable. The Importance of Early Cataract Removal: Dr. Flannery highlights how cataracts become more difficult to remove as they harden over time, making early intervention crucial for better surgical outcomes. Impact of the IV Fluid Shortage: Beyond cataracts, Dr. Flannery discusses the national shortage of IV fluids, exploring how this affects elective surgeries and the broader healthcare system. Surgeons Behaving Badly: In a lighter moment, Dr. Flannery shares a story about a surgeon who used a Swiss Army knife in place of a sterile scalpel, illustrating the strange and sometimes humorous side of healthcare. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you like the scrubs I'm wearing, here's a link and discount code to get some Jaanuu Scrubs link: https://bit.ly/4cAvXbs code: DRG20 for 20% off first-time purchases* *This code works on full-price items only excluding embroidery!  If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 Today's episode is brought to you by the Nuance Dragon Ambient Experience (DAX). It's like having a virtual Jonathan in your pocket. If you would like to learn more about DAX Copilot check out http://nuance.com/discoverDAX and ask your provider for the DAX Copilot experience. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

    ٤٦ من الدقائق
  4. ١٩ ربيع الآخر

    Glauc Talk: Balancing Parenting, Household Chores, and Careers in a Medical Marriage

    In this episode of Knock Knock Hi, we explore the challenges of balancing life in a medical marriage like managing household duties when both partners are running on empty. We reflect on the popular TikTok trend of "energy check-ins," where couples rate how much they have left to give at the end of the day, and whether it can work in a busy, often chaotic medical household. Adding to the fun, we dive into the lore of one of my most beloved characters—the Neurologist. I shares how the Neurologist was inspired by one of my real-life attendings, known for his intellectual superiority and sharp insults. Takeaways: Medical marriages can feel unbalanced, especially when one partner is always working long hours, which puts more household responsibilities on the other. Sleepwalking, stress, and medical careers can create unique challenges in a marriage, making communication and understanding even more important. The Neurologist’s sharp wit and expertise adds humor to the discussion of sleep and exhaustion, reminding listeners of the importance of brain health in relationships. TikTok relationship trends like “energy check-ins” might seem helpful but could backfire when both partners are constantly running on empty. Balancing a career in medicine with personal life requires patience, humor, and creativity—sometimes, even turning to social media trends for inspiration. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you like the scrubs I'm wearing, here's a link and discount code to get some Jaanuu Scrubs link: https://bit.ly/4cAvXbs code: DRG20 for 20% off first-time purchases* *This code works on full-price items only excluding embroidery!  If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit http://www.EyelidCheck.com for more information.  Today's episode is brought to you by the Nuance Dragon Ambient Experience (DAX). It's like having a virtual Jonathan in your pocket. If you would like to learn more about DAX Copilot check out http://nuance.com/discoverDAX and ask your provider for the DAX Copilot experience. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

    ٤٩ من الدقائق
  5. ١٤ ربيع الآخر

    Knock Knock Eye: Child Eye Problems You Shouldn't Ignore

    In this episode of Knock Knock Eye, I discuss important eye conditions in children that should never be ignored. From aggressive blinking and rubbing to the misalignment of eyes (strabismus), I explain how early detection of these symptoms can save a child’s vision. I also delves into congenital glaucoma, blocked tear ducts, and other common pediatric eye conditions, emphasizing the importance of timely diagnosis. Whether you're a parent or healthcare provider, this episode provides valuable insights on protecting children's eye health. Takeaways: Blinking and Rubbing May Indicate Vision Problems: Children who frequently rub or blink their eyes aggressively may have refractive errors, such as nearsightedness or farsightedness, which can be corrected with early intervention. Misaligned Eyes (Strabismus) Can Lead to Vision Loss: If one of a child’s eyes is misaligned or appears "lazy," this could indicate strabismus, which, if untreated, can lead to permanent vision loss (amblyopia). Tearing in Infants Could Be a Sign of Congenital Glaucoma: Dr. Flannery explains that excessive tearing in newborns may be an early sign of congenital glaucoma, a rare but serious condition that requires immediate attention. New Spots on the Eyes Need Examination: If a new spot appears on the white of a child’s eye, it’s essential to have it examined by an ophthalmologist, as it could be a benign nevus or something more serious, like a melanoma. Difference in Pupil Size (Anisocoria) Could Be a Red Flag: A noticeable difference in pupil size in children might be an indication of an underlying condition like Horner's syndrome or other neurological issues, and should be checked by a specialist. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you like the scrubs I'm wearing, here's a link and discount code to get some Jaanuu Scrubs link: https://bit.ly/4cAvXbs code: DRG20 for 20% off first-time purchases* *This code works on full-price items only excluding embroidery!  If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 Today's episode is brought to you by the Nuance Dragon Ambient Experience (DAX). It's like having a virtual Jonathan in your pocket. If you would like to learn more about DAX Copilot check out http://nuance.com/discoverDAX and ask your provider for the DAX Copilot experience. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

    ٤٤ من الدقائق
  6. ١٢ ربيع الآخر

    How Do We Combat Health Misinformation Online? | Dr. Noc

    We sit down with Dr. Noc (Morgan McSweeney, PhD), a social media influencer and expert in pharmaceutical sciences. We dive deep into how misinformation spreads on social media and the challenges scientists face when debunking it. Dr. Noc shares his insights on tackling myths around Big Pharma, drug pricing, and supplements, all while blending humor with education on platforms like TikTok. The conversation also touches on the balance between providing accurate science communication and the frustrations of dealing with online backlash. Join us for an engaging discussion on the power of science communication in an era of misinformation. Takeaways: Misinformation on social media spreads fast, and debunking it requires both patience and creative science communication. Pharmaceutical companies play a crucial role in drug development, but pharmacy benefit managers (PBMs) also contribute to high drug prices and often go unnoticed. Supplements are heavily promoted on social media, often with misleading claims; most people don’t need them, and they are mostly just expensive urine. Science communicators face challenges on platforms like TikTok, where algorithms isolate videos, and context is often lost. Connecting with people emotionally can be as important as providing evidence when communicating science and health information. — Want to Learn About Dr. Noc (Morgan McSweeney, PhD): TikTok / Instagram / Facebook / Youtube: @dr.noc — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you like the scrubs I'm wearing, here's a link and discount code to get some Jaanuu Scrubs link: https://bit.ly/4cAvXbs code: DRG20 for 20% off first-time purchases* *This code works on full-price items only excluding embroidery!  If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit http://www.EyelidCheck.com for more information.  Today's episode is brought to you by the Nuance Dragon Ambient Experience (DAX). It's like having a virtual Jonathan in your pocket. If you would like to learn more about DAX Copilot check out http://nuance.com/discoverDAX and ask your provider for the DAX Copilot experience. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

    ١ س ١٤ د
  7. ٧ ربيع الآخر

    Knock Knock Eye: 39th Birthday Reflections!

    In this episode of Knock Knock Eye, I reflect on turning 39 and how my medical history—surviving testicular cancer and a cardiac arrest—shapes my outlook on life and birthdays. Along with these personal reflections, I answer insightful YouTube comments, discussing topics like vision requirements for driving and Halloween eyeball decorations. I also dive into one of the scariest eye conditions for both patients and surgeons: Endophthalmitis, a dangerous post-surgery infection. Takeaways: Endophthalmitis: The Scariest Eye Condition: Dr. Flannery explains why Endophthalmitis is one of the most feared post-surgical complications, highlighting its symptoms, treatment, and the potential for severe vision loss. Reflecting on 39th Birthday: Dr. Flannery shares how surviving cancer and a cardiac arrest has shaped his perspective on celebrating another year of life, with both joy and a lingering sense of caution. Vision and Driving Laws: Responding to YouTube comments, Dr. Flannery discusses the surprisingly lax driving vision requirements in some states, like Wisconsin, and the potential dangers this poses to road safety. Halloween Eyeballs and Fan Comments: On a lighter note, Dr. Flannery enjoys a fun conversation with fans about his obsession with Halloween eyeball decorations, especially painting pumpkins and using inflatable eyes to bring a spooky twist to ophthalmology. Balancing Life as a Doctor and Comedian: Dr. Flannery talks about juggling two careers—ophthalmology and internet comedy—and how both bring him fulfillment, especially when he gets to engage with fans and answer their questions. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you like the scrubs I'm wearing, here's a link and discount code to get some Jaanuu Scrubs link: https://bit.ly/4cAvXbs code: DRG20 for 20% off first-time purchases* *This code works on full-price items only excluding embroidery!  If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 Today's episode is brought to you by the Nuance Dragon Ambient Experience (DAX). It's like having a virtual Jonathan in your pocket. If you would like to learn more about DAX Copilot check out http://nuance.com/discoverDAX and ask your provider for the DAX Copilot experience. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

    ٤٦ من الدقائق
  8. ٥ ربيع الآخر

    Glauc Talk: How My Biggest Social Media Mistakes Became Learning Lessons

    In this episode of Glauc Talk, we dive into the chaos of a stressful morning and explore how emotional regulation can make a big difference in managing everyday challenges. I also reflect on some of my biggest social media mistakes and the lessons I learned from those controversies, offering valuable insights for others navigating the online world. The episode touches on the importance of taking a pause before reacting, handling crises calmly, and learning from missteps. Additionally, we discuss the shocking cost of helicopter medical transport and how recent legislation aims to prevent surprise billing in these situations. Tune in for humor, personal stories, and practical lessons on stress management, social media, and navigating healthcare costs. Takeaways: Take a pause before reacting to stressful situations—waiting even a few minutes can help you think more clearly and make better decisions. Learning from social media mistakes can lead to growth, both personally and professionally. Owning your mistakes is key to moving forward. Helicopter medical transport can be extremely expensive, with costs reaching as high as $68,000, though legislation like the No Surprises Act helps regulate billing. Emotional regulation plays a vital role in handling life’s unexpected challenges, from stressful mornings to bigger crises. Staying grounded through mindfulness techniques, such as deep breathing, can help manage adrenaline-fueled reactions in high-pressure situations. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you like the scrubs I'm wearing, here's a link and discount code to get some Jaanuu Scrubs link: https://bit.ly/4cAvXbs code: DRG20 for 20% off first-time purchases* *This code works on full-price items only excluding embroidery!  If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit http://www.EyelidCheck.com for more information.  Today's episode is brought to you by the Nuance Dragon Ambient Experience (DAX). It's like having a virtual Jonathan in your pocket. If you would like to learn more about DAX Copilot check out http://nuance.com/discoverDAX and ask your provider for the DAX Copilot experience. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

    ٤٥ من الدقائق
٤٫٩
من ٥
‫٤١٥ من التقييمات‬

حول

"Knock Knock, Hi! with the Glaucomfleckens" dives into the highs, lows, and WTFs of healthcare. Whether you're in the medical field, live with a healthcare worker, or broke your arm once and are still paying off your medical bills, this is a must-listen. Join Will and Kristin Flanary (aka the Glaucomfleckens) for candid chats with leading healthcare voices like Dr. Mike and Surgeon General Dr. Vivek Murthy. Discover fun facts about eyeballs, hear relatable stories from medical training, and sneak a peek into the U.S. health insurance industry (spoiler alert: it's not great!). We'll share our own perspectives of being a patient or family member experiencing the healthcare system. And, of course, we explore the question on everyone's minds: "Why has Dr. Glaucomflecken never had his eyes dilated?" Combining science with humor and a dash of snark, we unpack the human side of healthcare.

للاستماع إلى حلقات ذات محتوى فاضح، قم بتسجيل الدخول.

اطلع على آخر مستجدات هذا البرنامج

قم بتسجيل الدخول أو التسجيل لمتابعة البرامج وحفظ الحلقات والحصول على آخر التحديثات.

تحديد بلد أو منطقة

أفريقيا والشرق الأوسط، والهند

آسيا والمحيط الهادئ

أوروبا

أمريكا اللاتينية والكاريبي

الولايات المتحدة وكندا