From the measurement desk

Written for the question you actually typed.

Each piece answers one owner question in the owner's words, with the measured data we have and arithmetic anyone can check.

The fee question

Should we start charging for no-shows?

The honest answer is "after you've built the maintenance, maybe." What fees actually fix, what they break, and the order of operations that protects both revenue and goodwill.

The mystery

Our patients confirm the text and still don't show — why?

Because confirming a reminder and defending a commitment are different systems. Where the confirmed no-show actually comes from, and the two steps that catch it.