Careers Succeeding at Work Presenteeism (and How Much It Costs Employers) Presenteeism Is a Serious Drag on Productivity and Contribution Share PINTEREST Email Print PeopleImages/Getty Images Careers Management & Leadership Human Resources Employee Benefits By Susan M. Heathfield Susan M. Heathfield Susan Heathfield is an HR and management consultant with an MS degree. She has decades of experience writing about human resources. Learn about our Editorial Process Updated on 06/25/19 You may not have heard of the word presenteeism, but you probably have heard of the much more common “butt-in-seat time.” Managers often judge employees based on how many hours they work rather than by their end product and contribution. This translates into dysfunctional thinking—if your boss can see you sitting in front of your computer screen you are seen as a good employee. This can lead to the issue of presenteeism. The "Harvard Business Review" defines presenteeism as “the problem of workers’ being on the job but, because of illness or other medical conditions, not fully functioning.” Many people come to work while ill or otherwise distracted by problems such as child care and chronic health conditions. While the employees are sitting at their desks, or working on the floor, their focus isn’t really on the work. As a result, you can experience a serious drop in employee performance. What Causes Presenteeism? Presenteeism stems from either internal or external pressure. A boss who sets unrealistic deadlines can cause employees to come in while sick (or work while on vacation, another form of presenteeism). When you receive a job offer, in addition to information on salary and benefits, you also receive information on paid time off (PTO). Vacation, holidays, sick days, and sometimes personal days are included in PTO. You need to consider them as part of your compensation package—and take them. However, some bosses strongly discourage employees from taking time off, even when they are sick. This illustrates the deep-seated idea that loyalty to the company and the job requires your presence at work. This version of presenteeism results in a culture where time off isn’t acceptable. This means that employees come in when they are sick. According to Jack Skeen, author of "The Circle Blueprint: Decoding the Conscious and Unconscious Factors that Determine Your Success": "The workplaces that make it the most difficult for workers to use vacation days or call in sick are the workplaces that will be the most likely to have poorly motivated staff. They come in resentful, overworked and completely unmotivated, whereas offices that encourage a strong work/life balance will have content and energetic workers." Additionally, an employee with an overdeveloped sense of duty can push herself to work when she really should take time off. Some bosses beg people to take time off for illness or vacation and yet the employee can’t bring herself to actually do so. If you’re worried that you’ll never catch up or that people will think you’re not that important, it can lead you to work when you shouldn’t. Isn’t More Work From Employees Better for the Business? You would think that the more hours worked by employees the better. But this is not true. Working while you're ill not only prevents you from working to the best of your ability, it can also infect your coworkers. A disease that makes you feel bad can be deadly to an immunocompromised coworker. So, when presenteeism happens in your office, you can end up with multiple people sick over weeks instead of one person out of the office for two days. It’s not just infectious diseases that are the problem. People who don’t take time off from work can suffer from stress and burnout. Stress can cause or exacerbate health problems, including deadly ones, such as heart attacks. Burnout makes it impossible for an employee to provide quality work. What Does Presenteeism Cost Businesses? The quick answer to what does presenteeism cost businesses is a lot. This is according to an American Productivity Audit which was completed using the Work and Health Interview (WHI), a "computer-assisted telephone interview designed to quantify lost productive work time, including time absent from work and reduced performance, while at work as a result of health conditions..." This study determined that the cost of employees working when they were ill surpassed $226 billion for employers. Researchers also figure that this is an underestimate since various factors such as not accounting for employee disability that leads to a continuous absence of one week or more were not counted. Dr. Olivia Sackett, Data Scientist at Virgin Pulse Institute, says that "We don’t hear as much about presenteeism. Its impact is harder to quantify thanabsence due to sick days. But, our data shows that, on average, employees took about four sick days off each year.” "But when employees reported how many days they actually lost on the job, that number shot up to 57.5 days per year–per employee." Reflecting this finding, according to the HBR article cited above, two articles in the "Journal of the American Medical Association" reported that employee depression cost US employers $35 billion a year in reduced employee performance at work and that pain conditions such as arthritis, headaches, and back problems cost employers nearly $47 billion. Another study, conducted by researchers in Japan, found "The monetary value due to absenteeism was $520 per person per year (11 percent), that of presenteeism was $3055 (64 percent), and medical/pharmaceutical expenses were $1165 (25 percent). Two of the highest total cost burdens from chronic illness were related to mental (behavioral) health conditions and musculoskeletal disorders. How to Fix Presenteeism Five solutions to the problem of employee presenteeism are immediately evident. Presenteeism is, at its root, a culture problem. As with all culture problems, fixing presenteeism starts at the top. Senior managers need to stay home when they are sick or unable to attend to their work for whatever reason. Period. It doesn’t matter how many sick days you offer, if the leadership doesn’t use them, the hard workers who want to climb the corporate ladder won’t either—no matter how sick they are. Supplying sufficient sick leave is also critical. An employee who wants to stay home to recover but has bills (all of them do), can’t stay home if the time off is unpaid. Likewise, employees need to use vacation time for vacation, not for working in a different location. Managers need to encourage employees to use their time off—you would never tell an employee that they have to take a pay cut because so much work needs to be done. But, when you deny the employees vacation time, you are cutting their pay—they get the same amount of money even when they do additional work. You need to create a work culture that recognizes that employees have lives—and let them live them. Providing comprehensive insurance can also allow employees to seek out a doctor’s help when they are ill rather than suffering in silence. Additionally, encouraging people to get their flu shots can really cut down on illness, and, therefore, both absenteeism and presenteeism. In another aspect of organizational culture, "When a worker feels like they are an invisible and unimportant part of their company, it’s easy for them to start feeling like their job doesn’t matter," says Skeen. "One of the best ways to keep workers on task is to make sure that every employee feels as though they matter, not just as workers, but as human beings." If you combine these solutions, you’ll have employees who take care of themselves and know that their bosses are okay with them taking care of themselves. And, you get to have people who can focus on their work when they are working, making everybody more productive.