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How to Address Presenteeism in the Modern Workplace

Presenteeism is the problem of lost productivity caused by employees working when they should be taking sick days to rest and recover. It’s kind of like the inverse to absenteeism, where employees regularly fail to show up at work without a good reason. Instead of being absent when they should be present, they’re present when they should be absent.

But unlike absenteeism, presenteeism isn’t always obvious. Invisible conditions can affect employees’ ability to do their work well, and the loss of productivity often goes unnoticed. At a glance, presenteeism may not seem like a big deal. In fact, some businesses encourage it—as though working while sick or injured were a sign of a good work ethic. They may suggest that a little determination can compensate for the loss in functionality. But when employees work at less than their full capacity, it comes with hidden costs.

The cost of presenteeism in the workplace

The bottom line is that presenteeism costs employers money. This happens in several ways.

One of the more obvious problems is the transmission of contagious diseases to coworkers. If one employee who has the flu chooses to stay home, you miss out on their contribution for a few days. But if that same person chooses to come into work, they risk spreading the flu to other employees.

You could end up with half of your workforce sick, instead of just one person. (Especially if they all continue coming in sick!) And that same illness will affect people differently. Some employees may feel like they can “power through it,” while others could be bed-ridden for days. And none of them had to be sick if that one person just stayed home.

However, something doesn’t need to be contagious to result in a loss of productivity. Let’s say that sick employee chooses to work from home instead of coming into the office. They may not infect coworkers, but they’re still operating at a reduced capacity. And by failing to get the rest they need, they’re likely prolonging their illness, resulting in even greater productivity loss than if they had simply taken the needed time off from the start.

Furthermore, when employees work while impaired, they’re not only less productive, but they’re also more prone to mistakes. And those mistakes may lead to additional problems down the road.

This loss of productivity has a tangible impact on your bottom line. According to a study on presenteeism by Global Corporate Challenge (GCC), while absenteeism costs employers about $150 billion per year, presenteeism costs about $1.5 trillion per year—ten times as much! Furthermore, the study found that while employees take an average of four sick days per year, they end up working while impaired for an average of 57.5 days per year.

Presenteeism is a problem whether your workforce is fully remote, hybrid, or in-person. Clearly businesses need to take this problem more seriously. So what causes presenteeism, and what can you do about it?

The causes of presenteeism

Multiple factors converge in the workplace to create a dynamic in which employees feel that they need to continue working while sick. Company culture, restrictive policies, and ongoing health issues can all contribute to this dynamic.

Workplace culture

American culture tends to idolize hard work to the point where we overlook health concerns. We see this idea all the time from movies and TV, self-help gurus, conferences, and op-eds: “Your value is connected to your output.”

Falling behind or even taking a break can feel like a personal failure. And beyond that broader perception, your own workplace culture could be contributing to the problem in ways you may not even realize.

Hopefully no-one is telling employees not to take sick days. But you don’t have to state it explicitly for employees to get the idea that they should just work through sickness.

It can be as simple as placing a heavy emphasis on meeting deadlines without simultaneously making it clear that your employees’ health is the priority. If you don’t say anything, employees may fear that taking sick days or falling behind on a deadline will cause them to be viewed negatively, passed over for a promotion, or even demoted or fired.

Some organizations make it worse by treating working through illness like a badge of honor. They may go out of their way to thank someone for working when they were sick, instead of encouraging them to rest. They may mention it favorably during reviews. Some even offer bonuses for employees who go a certain duration of time without using sick days. These interactions all normalize presenteeism and embed it within your workplace culture.

Competitiveness between employees can contribute to the problem as well, especially if they feel they must compete against colleagues for promotions, rather than work as a team toward shared goals.

Remote employees often feel like they no longer have a valid reason to take a sick day. Since they’re not coming into contact with coworkers, they can’t get them sick. And they still have everything they need to work at their fingertips. Their own need for rest and recovery may therefore end up taking a backseat. Keep this in mind if you have a hybrid or remote workforce.

Restrictive policies

In some cases, employees may fail to take sick days because they simply don’t have enough sick days available. If their sick days are too limited, they could run out part way through the year, at which point they will feel they have no choice but to come in sick. Or, in an attempt to avoid running out, they may ration their sick days, choosing to work through what they perceive as more minor illnesses to keep sick days available for when they feel worse.

The policy makes them feel like they have no choice but to work while sick.

Even if workers have enough sick days on paper, other barriers can prevent them from taking the day off. For example, some businesses require employees to get a doctor’s note before taking a sick day. This is not only an unnecessary task for them to accomplish while sick, but depending on their insurance and the fees of their personal doctor, it can often be prohibitively expensive. Employees frequently feel it simply isn’t worth the effort and expense to get the note, so they just work through their sickness. And it certainly doesn’t help that policies like that are rooted in a lack of trust.

Finally, if sick days are not paid time off, then any any sick day an employee takes results in a loss of income. No one wants to lose money, but especially for those who already have lower wages, missing a day’s worth of income can be devastating. For employees living paycheck to paycheck, it can mean being unable to pay their bills. If they have to choose between taking a sick day and missing their rent or mortgage payment, they’ll work while sick.

When employees don’t feel empowered to take the time they need to get healthy, presenteeism becomes more prevalent.

Ongoing health issues

In addition to temporary illnesses, presenteeism is often caused by chronic health issues like allergies, migraines, long-term injuries, and depression or other mental-health issues. In many cases, these ongoing problems stem from insufficient access to the medications or other forms of healthcare needed to address them.

People often learn to manage chronic health problems, but these issues can periodically become more intense or pronounced. If they feel pressure to work through those times, it contributes to presenteeism.

How to reduce presenteeism

Addressing presenteeism ultimately comes down to taking care of your employees. Not only will discouraging presenteeism improve their health and wellbeing, but it can also increase their productivity.

Start at the top

Solving the problem of presenteeism must involve a shift in mindset. Your leadership personnel have an immense impact on employee behavior. How you talk about sick days and health affects how comfortable people feel taking sick days—and so does your behavior. If you don’t take sick days yourself, employees will feel greater pressure to work through their own illnesses and injuries.

Make your priorities clear

Remember that even if no one is explicitly discouraging people from taking sick days, the tension is there. You’ll need to explicitly encourage using sick days to reverse the trend within your organization. You need to clearly communicate your priorities and sick-day policies to all employees. Explain the health and productivity benefits that come with taking sick days as needed, and let them know that employee health will always be a priority.

Don’t leave them guessing about how taking a sick day will affect the perception of their work. Assure them that not only will they not be penalized for taking needed time off, but that doing so will be seen as a positive contribution toward a healthy workplace. Make it clear that the number of sick days taken won’t be a determining factor in promotions or downsizing.

Actively encourage employees to take sick days when it becomes apparent that they need them. Assure remote workers that they too should take the day off when they need to recover. Instruct managers to keep an eye out for employees working while sick or otherwise impaired, sending them home as needed. Similarly, be sure that managers never encourage working through sickness to meet deadlines.

If you have them, remove any incentives for working through illness, including rewards for unused sick days. Consider replacing these with rewards based on healthy workplace practices or participation in wellness programs.

Rewrite any policies that put barriers in the way of employees taking sick days. In particular, eliminate any requirements to “prove” illness, such as acquiring a doctor’s note. These policies encourage presenteeism.

Finally, make this a two-way conversation with your employees. Survey them anonymously, asking questions like:

  • “How often do you need to take sick days?”
  • “How often do you actually take sick days?”
  • “How often do you work through sicknesses?”
  • “What reasons would cause you to avoid taking sick days?”
  • “What do you need to feel comfortable taking them?”

Incorporate their feedback into your sick day policies and discussions moving forward.

Be generous with benefits

Your local ordinances most likely require you to provide certain amounts of time off, but meeting those baseline legal requirements is rarely sufficient for creating a flourishing workplace. When you go above and beyond to provide generous benefits, you can tackle the root problems that cause presenteeism in the first place. Additionally, these benefits demonstrate that you care about your employees. They can improve employee satisfaction, create loyalty, and attract prospective hires.

The most obvious benefit that helps tackle presenteeism is paid time off. If your employees don’t have enough (or any) paid time off, they’re going to work while sick. They should never have to choose between getting the rest they need to recover and getting their paycheck. So make sure they always have enough paid time off to cover their health needs.

Equally important is providing your employees with quality health insurance. Taking a sick day when needed is good; preventative healthcare that keeps people from needing a sick day in the first place is even better.

But if your workplace insurance comes with high deductibles, large co-pays, or lots of out-of-pocket expenses, employees will treat healthcare as a last resort, and they’ll likely get sick more often (and for longer). This is especially true for those with ongoing health issues who require regular medications or treatments to be at their best.

You can also invest in wellness programs for your workplace. These can include things like adding a fitness center to your workplace or paying for memberships to a local fitness center, coordinating healthy group activities for employees, providing healthy food and drinks, hosting on-site exercise classes like yoga or tai chi, or offering incentives for employees to track health-related goals.

Finally, you might even consider an alternative workplace model. It would represent a bigger change, but if executed well, concepts like activity based working, flexible hours, or hybrid workplaces all have the potential to promote greater health among employees.

Learn more about The Future of Work

The way we work is changing. Whether your employees are fully in-person, fully remote, or somewhere in between, the last couple of years have forced your workplace to evolve.

The Future of Work newsletter explores the latest workplace trends, studies, and headlines, giving you insights you can apply to the office. Once a month, we’ll share our findings with leaders like you.

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Contributors

Brett Sample

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