Presenteeism: Cost, Causes and Solutions

Presenteeism – employees who come to work sick, or suffering other conditions that prevent them from working productively – may be costing you more than absenteeism. Here are causes and solutions for presenteeism.

It’s no secret that absenteeism is a major expense for small business. In fact, according to the The Centers for Disease Control and Prevention (CDC), productivity losses linked to absenteeism cost employers $225.8 billion annually in the United States, or $1,685 per employee.

But as high as those numbers are, presenteeism may be a greater expense for businesses. Workers who are present but not working up to capacity due to illness or other health factors cost US businesses billions of dollars more every year.  A survey Virgin Pulse Global Challenge, for instance, shows employees in their study averaged 4 sick days a year, but indicated that the time they lost while on the job (ie, being present by not working productively) added up to a staggering 57.5 days per year per employee

What is presenteeism?

In case you’re unfamiliar with the term, presenteeism was coined to define the practice of workers reporting to work when ill, overly fatigued, or for other reasons not operating to their usual level of productivity.  

In addition to not being effective at their own job, people who come to work when sick are also likely to infect others; namely, coworkers and possibly customers or clients. In occupations such as nursing, and industries such as food service, an infected employee who comes to work ill can spell disaster — compromising food safety, and infecting and sickening the public, to name a few.

RELATED: How to Handle Employees Who Are Chronically Late or Absent

In 2004, the Harvard Business Review reported on a study conducted by researchers at Tufts-New England Medical Center in Boston. The study assessed the impact of twenty-eight medical conditions on workers’ productivity at Lockheed Martin Corp. The findings showed that employees who came to work sick that year — with ailments such as allergies, headaches, lower-back pain, arthritis, colds and the flu — set the company back about $34 million. Allergies and sinus trouble led the pack with the highest losses to the company of $1.8 million.

Causes of presenteeism

There are many reasons for presenteeism in the workplace. Among them:

  • Dual-earner and “sandwich generation” households – Dual-earner families account for 48% of all married couples, according to the Bureau of Labor Statistics. Without a stay-at-home spouse to care for a sick child, many workers will go to work when they, themselves, are ill in order to save their limited sick days for when their children are sick. Added to the mix are the 25 million American workers who provide informal care for an elderly family member or friend who needs help with basic personal needs and daily activities.  Those who care for aging parents as well as their own children are called the “sandwich generation.”
  • Employer expectations – In today’s often “leaner-and-meaner” workplaces, some workers trudge off to work when sick because they fear one or more of the following: appearing less committed to their jobs, receiving disciplinary action, or even losing their jobs. A day or more off can also mean burdening coworkers with job duties, coming back to a heavy backlog of work responsibilities, or missing work deadlines.
  • Little or no paid sick days – A 2017 report from the Bureau of Labor Statistics shows that on the average, 68 percent of private industry workers have access to paid sick leave. But the highest percentage of workers who receive paid sick leave fall into management and finance occupations. The average percent  of workers in service and construction jobs that get paid sick leave is respectively 46 and 47 percent.  As a result, many workers are reporting to work when ill to avoid loss of pay. 
  • Loyalty and Self-importance – Still others come into work when they are sick because they “dont want to let the team down,” think no one else can do their job, or that the business will suffer if they aren’t there. 

Employer solutions for presenteeism

  1. Recognize the problem – The first step in solving a problem is often recognizing there is a problem in the first place. Presenteeism is often unrecognized by employers who may not realize the extent of loss it can cause. If you’re a business owner, it’s time to make managers aware of this problem and that the costs of presenteeism are rising. A business that ignores the problem of presenteeism is a business that may very well have it adversely affect its bottom line.
  2. Rethink the use of disciplinary action to control absenteeism – Employers need to examine and ensure that absence control policies are not counterproductive. Programs such as disciplinary action may in fact pressure sick employees to report to work; this inadvertently encouraging presenteeism.
  3. Develop a workplace policy on presenteeism and inform and educate employees – Employees need to know where your company stands on coming to work sick, and how doing so can infect others. Establish and communicate guidelines. Help employees understand under what conditions they should stay home, and when it’s OK to return to work. 
  4. Don’t set a bad example. As the boss, if you are sick or unable to work effectively, stay home. Don’t spread your germs to others in the office. If you feel you must be available to handle emergencies, do so on the telephone or by email. 
  5. Take disciplinary action, when necessary. In workplaces where the protection of the public is critical and essential to staying in business, employers may want to take disciplinary action or dismiss workers who are found in violation of company policy. One worker, for instance, went to work ill at a popular food chain establishment. As a result of doing so, this employee infected more than 400 customers whose symptoms included vomiting and uncontrollable diarrhea. 
  6. Send sick employees home. Many companies with presenteeism problems report that they also try to combat the issue by sending sick employees home. They strive to foster a culture that discourages employees from coming in sick; where employees are not made to feel that they must go to work even if they are ill. Where possible, employees are given the option to telecommute and work from home when not well.
  7. Provide Paid Sick Leave and/or Paid Time Off to Workers. If you don’t already offer paid sick days, consider doing so. In addition to providing a desirable benefit to your employees, you may benefit from reduced employee turnover, higher productivity and by reducing the spread of contagion in the workplace. 
  8. Make an Effort to Boost Employee Morale.  According to the CCH survey, morale had a significant impact on the incidence of presenteeism. They found that companies with low morale had more ill workers showing up for work. In their study, 52 percent or organizations with “poor/fair” morale reported presenteeism was a problem; this compared with just 31 percent of organizations with “good/very good” morale seeing presenteeism as an issue. One way to boost morale is to provide some degree of flexibility in employees’ work arrangements. Employers who do so help employees meet the pressing demands of both work and family, and aid in their achievement of a healthy work-life balance.

The image of an employee who comes to work sick-as-a-dog as a dedicated and valued worker is no longer apropos. Presenteeism costs are a real and potentially significant drain on a company’s financial well-being. Employers need to make a concerted effort to develop a workplace with healthy and highly functioning workers. This will go a long way toward meeting goals for company productivity and profits, and fostering a healthy work culture and environment for employees.

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