I spoke with Marketing...the email list we use is generated from every email address we have on file for each practice. It is not just a subset. When we send an email we receive back a confirmation that it was delivered to your server "Delivered" and if you click on it to open it we receive an acknowledgment of that as well "Opened". We're not being big brother here..this is the way every email service works in the world. When you click on an email the sender thinks you're interested in their product and will send you more emails:-)
In both cases for Chris and Josue we see them as being delivered and opened. Josue, in your case it was opened 4 times.. Here's the crazy part...your office manager shows opening it 41 times. ..Now I have no idea of how this works so don't shoot the messenger here..I can only tell you what we see from our end. It's possible you have some email scrubbing/monitor software that opens and scans these for viruses...We have that here on our corporate servers. but i don't know how that appears to the senders.
Also./.those inbox messages get pulled down from a service that runs periodically on your server..it's not instantaneous...I had to wait 3 days before i saw the message in my test database but my demo is ot on all the time
hope that helps for what it's worth...