Managers may be pleased to see all their employees at work, but it's not a good thing if some of them are ill or hurting. The problem is called presenteeism, defined as employees coming to work sick or injured, keeping them from being fully productive. Workers who aren't feeling well can't function at their best, no matter how dedicated and skilled they may be. And during this pandemic, having a worker show up sick with COVID could shut down your entire operation, so encouraging sick employees to stay home is crucial.

Musculoskeletal disorders and illness can disrupt employee's concentration and cause mistakes, which can be costly and time-consuming to fix. If part of a team, others may step in to cover for the ailing member, bringing down the whole group's productivity and morale. And if that worker is infectious, others in the department could catch the illness and further spread the impact.

Signs of Presenteeism

Unlike absenteeism, which is easy to track, it's harder to measure which workers are in discomfort. Telltale signs include workers making mistakes or working more slowly, reducing their work quality and quantity. If the employee looks fatigued or shows pain, they may not be ready to return to work.

Five Factors Contributing to Presenteeism

Why don't hurting employees take sick days or get treatment rather than coming to work? Here are five ways your organization's policies or culture may be causing presenteeism in the workplace:

1. Fear of Job Loss: This cause is especially prevalent in regions and/or industries experiencing job cuts and restructuring. Workers hoping to prove their worth and dedication may not take sick time. Older workers, fearful of being replaced by younger, healthier personnel, may hide pain or disability and try to "muddle through."
2. Loyalty to the Company/Team: Some workers may feel guilty taking time off because they don't want to burden their coworkers with extra work and stress. If there's a heavy workload, the worker may fear missing a deadline or not being seen as a "team player."
3. Lost Time Days: An ailing employee may feel the pressure to come to work because they know that their workload will either require their teammates to work overtime or their supervisor may have to step in to ensure their work is completed.
4. Company Culture: In some organizations, it's considered a badge of honor to come to work even when tired, sick or in pain. If your company has restrictive work policies that discourages absences even with paid sick days, workers will avoid taking needed time off.
5. Saving Time Off: If an organization has a set number of "sick days" per year, employees may save those days to care for a sick child/spouse, rather than using them when they are ill or injured.

How to Treat Presenteeism

Minimizing presenteeism at work can save you money while creating a safer, healthier environment for employees.

With the associated high cost of injured workers, physical therapists are in a unique position to help employers manage these concerns via multidisciplinary injury prevention programs, education, onsite treatment, and return to work programs. By participating in proactive ergonomics and onsite treatment services, physical therapists can decrease work-related musculoskeletal disorders and the costs associated with those injuries, reduce absenteeism/presenteeism, and improve workers’ health and work productivity.

The key to treating presenteeism is letting employees know their wellbeing matters as much as their work does. Managers can demonstrate this by reassuring employees that it’s ok to take sick days and not coming to work when sick themselves. Updating sick time policies and management attitudes may encourage workers to report their symptoms, take needed time off and/or get onsite treatment for their discomfort. Investing in workplace wellness programs such as ergonomics, health screenings, and early intervention for injuries can build employee trust and reduce presenteeism, resulting in a happier, healthier workforce.