RelyMD Blog

Presenteeism in the Workplace: How to Keep Your Employees Healthy and Productive

Workers are the backbone of your company. So what happens when they get sick? Rather than take a day off, many workers are chugging the cough syrup, loading up on pain medications, and heading into the office armed with tissues and hot tea. This kind of dedication to the job must be of great benefit to your company, right? Unfortunately, this isn’t quite the case. Presenteeism is a growing problem, but luckily, we have a few key ways to help you combat it.


What is Presenteeism?

Presenteeism, simply put, is whenever an employee decides to power through an illness and show up to work despite feeling terrible. As a result, presenteeism causes productivity loss, poor health, exhaustion, and workplace epidemics.

Presenteeism isn’t always obvious. You can always tell when a worker is absent, but with presenteeism, that employee will be there at their desk, sitting in front of their computer. While they are physically present, if they’re sick, they’ll be in a completely different place mentally. This is especially true if the problem is an invisible illness like migraine, depression, or chronic pain.


Why Are Workers Choosing Presenteeism Over Absenteeism?

Absenteeism, which is when workers take time off work because of sickness, has historically received extensive attention in the management sciences. This is because of the harsh consequences of taking a sick day. According to the Bureau of Labor Statistics, only 71 percent of workers in private industry had paid sick leave benefits. For everyone else, that means taking a sick day equates to no pay—a problem many people simply can’t afford. Showing up to work, even if they’re only giving 50% effort, suddenly becomes a much better choice.

Most workers have between seven to eight sick days a year, but fewer than half of these workers can carry their sick days over to the next year. That means that if an employee is struck down with a more serious illness than the common cold, they may not have enough days to cover their recovery. The CDC recommends that even for something as commonplace as the flu, people should still wait 24 hours after their fever has subsided to return to work—a process that could take up to five days. This could wipe out their entire surplus of days in a single illness, meaning they’ll be forced to return to work unless they want to face unpaid time off or disciplinary consequences.

In many cases, people simply don’t want to miss work to see a doctor or to rest through the illness. The average wait time for a new patient-physician appointment has risen to an average of 24 days, meaning it’s not really possible for an employee to get the sick care they need on an urgent basis. The longer the wait, the more likely the patient will just skip routine or preventative medicine appointments, leading to a higher risk of health problems. Perhaps because of this, 17–28% of U.S. men and women do not have an established healthcare provider.

With all of this in mind, the bottom line is that unwell employees who don’t take their job lightly would prefer to continue working through an illness if they can. Unfortunately, this isn’t really in your best interest.


How Presenteeism is Affecting the Workplace

It’s clear that more and more people are slogging their way into work when they’re not feeling well. So how exactly is this affecting your workplace’s productivity? Research shows that presenteeism can lower individual productivity by one-third or more, but these effects are not always so clear-cut because not all illnesses produce quantifiable symptoms.

For example, certain chronic conditions can produce symptoms that are uncomfortable for the worker but don’t necessarily set off red flags. People with diseases like irritable bowel syndrome or gastroesophageal reflux disease might be distracted by heartburn, stomach pain, and trips to the bathroom, which can detract from their focus. Other problems that may be difficult to detect, such as depression or anxiety, can make a person irritable and tired, which can drastically affect their ability to collaborate in a team or interact with clients.

Researchers have found that less time is lost when people stay home as opposed to showing up but not performing at full capacity. For example, a 2018 study that looked at healthcare expenditures among Japanese workers found that the total cost per person per year of presenteeism was $3,055, compared with just $520 for absenteeism.

Another survey called the American Productivity Audit talked to 29,000 working adults and estimated that the total cost of presenteeism in the United States is more than $150 billion a year. Meanwhile, the cost of lost wages from absenteeism was $117 billion—still a large chunk of change, but far less than workers trying to get things done when they’re not mentally able to.

These numbers are huge—so large, in fact, that they’re costing companies more than they spend directly on medical treatment and drugs. At the end of the day, presenteeism costs employers two to three times more than direct medical care for their employees, including things like insurance premiums or employee claims.


How to Reduce Presenteeism in Your Workplace

Now that you’ve learned more about the impact of presenteeism in your workplace, it’s time for you to get the ball rolling and implement policies that will change the system. Use the following strategies to limit how many of your employees are working through issues that are putting their productivity at risk:

  • Get to know the particular health issues that impact your employees.
    This might involve taking a survey to learn about what conditions people in your office have. For example, maybe a majority of the people in your office are suffering from arthritis, which can make it painful to type or sit at a desk all day. You may be able to offer modifications to help people be more comfortable, such as adjustable desks or more ergonomic chairs.


  • Educate employees about presenteeism and encourage them to take the time they need to receive healthcare and to rest and recover.
    In many cases, sick employees don’t realize how they’re contributing to a culture of illness by coming to work when they’re not well. By explaining the concept of presenteeism and instead promoting absenteeism, you may be able to convince more people to stay home and get the rest they need to feel better. To make staying home more of an incentive, see if it’s possible to offer more sick days or require unwell employees to get a doctor’s note saying they’re good to return to work.


  • Educate employees on healthcare resources that make it easier to get healthcare easier.
    An example of this comes from the company International Truck and Engine, which hired an allergy specialist to come in and provide free consultations during the workday. This inspired at least one employee to go to a follow-up appointment, where she found she had an additional allergy that was causing irksome symptoms. After getting the right prescriptions, she estimated that her productivity probably increased by as much as 25%.


  • Make sure your healthcare benefits are up to snuff and include services that make getting healthcare easier, like telemedicine.
    As previously mentioned, it is notoriously difficult for employees to get an appointment with a doctor. It’s easier to simplify the process when you offer more accessible healthcare options. Take a good look at your current healthcare benefits and make sure they’re comprehensive and affordable. For example, if your HMO doesn’t have any general practitioners that have a wait time less than 20 days, see if you can expand to a PPO to give your employees more options.


Healthier Employees Equal Better Results

At the end of the day, doing your part to ensure that your employees are healthy and happy will reduce rates of both presenteeism and absenteeism. By taking the time to improve the healthcare outlook in your company, you can boost productivity and reap more profits than ever before. Certainly, you aren’t responsible for making sure your employees eat well, follow an exercise routine, and see their doctor regularly. But by offering up programs and simplifying the healthcare process, you can make it as easy as possible for them to lead healthy lifestyles and only show up to work when they’re feeling 100%.

Is your organization suffering from presenteeism? Contact us to learn how 24/7 access to virtual healthcare can help.





Case Study
UNC Lenoir Health Care Case Study