If you have never heard the term presenteeism before, I’ll bet you are a bit confused.

After all, aren’t we supposed to be present and mindful and all that?

Presenteeism is a term for working while sick.

Absenteeism is a term for not working while sick.

I’d like to throw a memory bomb your way. Think back to last allergy season. How many days were you working through congestion, sneezing, coughing, headaches, etc.?

Seriously, how many?

You know you felt awful. You worked anyway.

How productive were you? On a scale of 1 to 5, with 1 being completely unproductive and 5 being “in the zone,” where did you fall?

If you played the numbers game with me above, you just participated in a research study on presenteeism (with a sample size of one).

Wellness programs in organizations are wonderful things. They often measure their success using metrics such as:

• Reduced absenteeism
• Reduced health care costs
• Increased preventive healthcare service utilization

I wonder how many organizations track the impacts of presenteeism. My unscientific guess is “not many.”

The first reason is that productivity losses due to presenteeism are primarily measured through self-report. I tell you when I worked while sick. I tell you how productive or unproductive I was. While self-report measures are used quite a bit in leadership assessments and the like, they garner skepticism in some spheres.

The second reason that presenteeism is rarely measured is that several of the larger research studies were sponsored by pharmaceutical companies. Big Pharma may garner skepticism for other reasons.

Those two factors may cause HR departments to give this body of research the side eye.

However, you and I know the impact that working while sick has on our productivity. We feel miserable and likely perform miserably. So, that’s where I want to focus the remainder of this article.

We may not be able to change how our employers view presenteeism, but we can examine it for ourselves and our teams.

What type of worker is prone to presenteeism?

 

Here’s another game. Answer the following questions.

What type of person is more likely to work while sick?

• A regular/permanent employee or a temporary/seasonal one?
• Someone working in a privately owned hospital or in a public hospital?
• Someone who sees their work as “a means to an end” or as a calling?
• Someone who knows they can be replaced, or someone who feels irreplaceable?
• A person with a poor diet and less emotional fulfillment, or someone who is physically fit and reports overall emotional wellness.

To answer these questions, I’ll tell you about a fictional person named James. James is a full-time employee at a public hospital who feels that his work contributes to the greater good and is part of his identity.

James has worked at the hospital for many years, and his team feels more like family. He has a lot of responsibility in his department, and when he goes on one of his very infrequent vacations, he spends most of his “days off” checking work email. While at work, he grabs whatever food he can from vending machines and goes home exhausted every night.

James has had perfect attendance for the past three years. James has major depressive episodes three to four times per year. People call him, “The Machine.”

James shows all the risk factors for presenteeism.

Here are the productivity-related implications for James (and the hospital!) when he works while sick:

• His decision-making is impaired.
• He works more slowly.
• He is irritable with colleagues and patients.
• He is more likely to have a workplace accident.
• If his illness is communicable, other people may become sick.

Are you James (or someone like him)?

Scholars doing research on presenteeism typically focus on chronic illnesses such as:

• Allergies
• Asthma
• Depression
• GERD (gastroesophageal reflux disease)
• Irritable bowel syndrome
• Migraine headaches
• Musculoskeletal conditions

The illnesses listed above have larger impacts on presenteeism.

Other health conditions tend to have almost equal effects on both presenteeism and absenteeism.

To better manage your own productivity losses due to presenteeism, consider the following:

• Working while sick is not a badge of honor, even if other people at your organization seem to think so.
• Workaholics may be less likely to seek medical care for what they deem “annoyances.” Feeling like heck is not a cost of doing business.
• Challenge yourself to get your regular checkups with your healthcare provider. Know what health-related issues affect you. Knowledge is power.
• If you feel that there is “something wrong” with your body, advocate for yourself with your healthcare providers and your employer. Some conditions such as irritable bowel syndrome are frequently misdiagnosed.
• Get your flu shot. Programs providing free flu shots at work are the most successful workplace presenteeism (and absenteeism) prevention initiatives in history. Personally, I’d add COVID shots to this recommendation as well.

Oh, and, maybe…just maybe…rest when your body needs you to?

I scoured the 250+ articles on my blog, and want to offer the following posts for further reading on the important topic of health and work:

• How to address the causes of workplace stress
• 3 Reasons You Haven’t Used Your Vacation Time (And Why You Should)
• Random Acts of Kindness…er…Productivity!
• Is work keeping you up at night…literally? Here’s how to deal.
• Meditation for Productivity
• Productivity and Pain
• Perimenopause and Productivity

 

In my two-hour seminar, Confront Your Time Thieves…interruptions, procrastination and, oh yeah, distractibility, I talk about how we should strive to reduce our time thieves. We will never eliminate them altogether, and efforts toward that extreme goal will be unproductive. After all, we are human.

My philosophy with absenteeism is similar. We should strive to reduce unnecessary absences – for ourselves and for our organizations. But, when we overreach with absence-prevention programs or cultures, we are likely to increase presenteeism.

And presenteeism isn’t the goal – at all.

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Melissa Gratias (pronounced “Gracious”) used to think that productivity was a result of working long hours. And, she worked a lot of hours. Then, she learned that productivity is a skill set, not a personality trait. Now, Melissa is a productivity expert who coaches and trains other businesspeople to be more focused, balanced, and effective. She is a prolific writer and speaker who travels the world helping people change how they work and improve how they live. Contact her at getproductive@melissagratias.com or 912-417-2505. Sign up to receive her productivity tips via email.