Presenteeism: The hidden cost of employees showing up sick

We all have off days when we’re not feeling well and can’t be as productive as usual. It happens to everyone, even your star employees. Someone gets sick, gets an overuse injury, or feels burned out from work stress and can’t perform at their typical level but still shows up for work.

This is called presenteeism. As a one-off, this isn’t a big deal, but when it becomes more widespread within your organization, it can become a bigger problem.

Gone are the days when showing up no matter what should be encouraged. Employees need time off to rest and recover so that they can get back to doing excellent work. Find out what causes presenteeism and what you can do to prevent it in your organization.

What is presenteeism?

Presenteeism occurs when employees are physically present but not functioning at total productivity due to illness, injury, disengagement, burnout, or other factors. This results in decreased job performance and productivity.

Presenteeism is prevalent as many people hesitate to take time off when needed due to a lack of PTO, concerns over job security, and other factors.

Presenteeism vs. absenteeism

Absenteeism is a pattern of absences, typically unplanned or unapproved, like last-minute callouts. It differs from presenteeism, where employees are physically present in the workplace despite being unable to work at their full potential.

Still, the two issues share many of the exact causes and contributors. Both can be due to burnout, employee health issues, and disengagement.

The two issues notably differ in how they present themselves in the workplace. Absenteeism is typically readily apparent to managers and even co-workers, but presenteeism can be harder to identify. Presenteeism is sometimes apparent, such as when someone comes in noticeably ill.

However, it can also be subtle and may only be noticeable to employers that quantitatively measure worker productivity.

Causes of presenteeism

Presenteeism can stem from a wide array of issues. Explore the top causes, from illnesses to problems within the work environment.

Burnout

Burnout is a state of physical, emotional, and mental exhaustion that stems from prolonged stress. It’s a common issue in the workplace, particularly for employees who have high workloads, work long hours, or don’t get enough time off to rest.

Burnout can last for extended periods if not adequately addressed, possibly resulting in long-term presenteeism.

Illness

Sickness presenteeism is common when sick employees come into work but lack the energy and focus to perform well or work productively. Most of us experience some fatigue while sick, so it’s understandable that employees may feel tired and less motivated while dealing with an illness.

Many illnesses like the flu or COVID-19 also have cognitive symptoms like brain fog that may make it hard for employees to stay focused on completing tasks properly.

Injury

Injuries can also cause presenteeism. That’s why it’s essential to prioritize workplace safety and ergonomic design within employee workspaces. If someone is experiencing muscle strain or injury, they won’t be able to work at their whole level, and even worse, they may experience pain while working.

The recovery period for injuries is often several weeks or months, and most people can’t afford to take that much time off. This leads to presenteeism as employees physically return to work but still need time to heal and ramp back up to everyday productivity.

Employee disengagement

Disengaged employees may continue to show up to work, but their productivity and focus will typically decrease, leading to presenteeism.

Disengagement can co-occur with burnout or exist separately. Factors that can contribute to disengagement include:

• Dissatisfaction with compensation
• Poor communication from managers or leadership
• Inadequate employee recognition efforts
• Satisfaction with workplace policies (such as in-office vs. remote work options)
• A lack of growth opportunities

Toxic workplace cultures

Many companies have created a presenteeism culture that makes employees hesitant to take time off when needed, leading them to push themselves too hard. At the same time, they’re sick or battling burnout, exacerbating the issue.

Some workplaces push unrealistic productivity standards. Some managers react poorly to employees taking time off. This can lead employees to show up to work. They might not feel mentally or physically healthy enough.

Inadequate paid time off

Employees who need access to enough PTO to cover their absence are forced into presenteeism. Even if they have a short time off balance left, many employees hesitate to dip into their PTO bank if they only get a few days of sick leave per year.

Many employees choose to come to work even when they know they are not feeling well. They might even be contagious. These individuals do this to save their limited paid time off. They want to keep it in case they need it later for an emergency or a more serious illness.

The cost of presenteeism

While perfect attendance and pushing through illnesses used to be celebrated as a show of dedication, presenteeism has several negative consequences for employers. Here are the most significant costs of presenteeism.

Lowered productivity

The apparent consequence of presenteeism is lowered productivity. When an employee comes into work feeling sick, exhausted, or injured, they won’t be able to work at their typical level of productivity. This can lead to decreased work output, missed deadlines, or lower-quality work.

Spreading illnesses in the workplace

If employees physically come into the office or workplace while sick, there’s a high chance that they will spread that illness to others (unless it’s a chronic illness that is not contagious). Many employers have become more aware of this concern since the onset of the COVID-19 pandemic.

However, many companies still have a culture that encourages team members to show up and be powerful through illnesses.

Decreased employee morale

The employees demonstrating presenteeism will show up to work, but they probably want to be elsewhere. Even worse, they may feel some resentment towards their employer and team.

Working when you’re feeling ill or overly exhausted isn’t a positive experience, and it may not lead to positive attitudes and morale. Unfortunately, one employee demonstrating low morale or a negative attitude towards work can affect the team’s morale.

Therefore, it’s often best to let employees rest and return when they feel better physically and mentally.

How to combat presenteeism

With so many potential causes of presenteeism, preventing the issue may seem complex. However, there are several steps that you can take to minimize or prevent presenteeism.

Provide well-rounded benefits

Ensuring that employees have access to healthcare is vital to minimizing presenteeism. You want your team to address any injuries and illnesses with a medical provider. The goal is to get them back to feeling healthy as quickly as possible.

Benefits like wellness programs or employee assistance programs (EAPs) can also support overall employee well-being and ward off issues like burnout that can cause presenteeism.

Better benefits packages also promote higher levels of job satisfaction, which can help combat presenteeism caused by disengagement.

Encourage employees to use PTO

The productivity loss from presenteeism is often equal to or greater than the lost productivity from an employee just taking a day off. Resting helps the recovery process, regardless of whether the employee is dealing with sickness, injury, or burnout.

When someone keeps pushing through instead of taking a sick day, the problem will likely persist and result in a more extended period of presenteeism.

Encourage employees to use their PTO for sickness absences or more extended vacations to fend off burnout. This not only helps the individual employee rest and recover properly.

Also, it can keep the illness from spreading throughout the workplace, which will harm your employees’ well-being and lead to more presenteeism in the following weeks.

Consider flexible work policies

Sometimes, flexibility can help ward off presenteeism. Commutes can certainly be fatiguing and may significantly elongate the employee’s work day if they’re coming and going during rush hour.

Remote work options and hybrid schedules are popular solutions. Adjusted work hours that help commuters avoid peak traffic is another option that can often reduce feelings of exhaustion and burnout.

One thing to remember is that in-office mandates can sometimes contribute to presenteeism. Suppose employees are forced back into the office for an in-person or hybrid schedule.

In that case, they may exhibit presenteeism due to disengagement and frustration or simply because in-person work doesn’t suit them well and causes them to be less focused and productive.

Flexible policies can also support employee work-life balance and mental health. Sometimes, that means allowing employees to shift their work hours. This alleviates stress around family responsibilities like school pick-up or drop-off. Or, it may mean giving people the flexibility to take longer lunch breaks. They can then hit the gym or attend a mid-day pilates class.

This flexibility may only work for some roles, but it can be impactful in helping employees feel and work their best.

Identify causes of disengagement and burnout

Discover why your employees feel burned out or disengaged. Use employee engagement questionnaires. They offer a great way to check in with your team. Solicit anonymous feedback on benefits, PTO policy, workload distribution, and other factors influencing presenteeism.

You can also look for guidance on your work policies and culture, such as understanding whether employees feel comfortable taking time off when needed or about your remote work options.

Be accommodating to employees dealing with health issues

Long-term injuries or chronic health conditions will often lead to some degree of presenteeism, as it’s usually simply not practical to call out every day they feel sick or for the entirety of their injury healing period.

Even those who qualify for extra time off under the FMLA may still want to come to work, as FMLA is unpaid. In these scenarios, minimize the impact of presenteeism. Find ways to accommodate the employee. This is the best approach.

The employee may qualify for ADA accommodations for chronic health problems, including mental health conditions. Short-term injuries may or may not meet the criteria, depending on the nature of the injury and its impact on the individual.

Work with the employee. Find ways to accommodate their needs. This helps them be more productive and engaged at work. It also minimizes the business impact of presenteeism. This approach works regardless of the situation.

More Resources:
Succession planning 101: A step-by-step guide for small businesses
Employee value proposition in action: Compelling real-world examples
Learning and development programs: A guide for professionals