What of presenteeism?
Most of us know firsthand the loss of productivity and impact that absenteeism has in the workplace. It is not a completely unknown or foreign concept. When we take time out of work for being sick we may actually feel guilty for being absent knowing the burden it will place on someone else who will have to do the work in our stead. We know this from experience. When one of our coworkers is out sick, we are the one onto which their responsibilities fall, the one who is asked to do their work until they return.
Alternatively, in considering whether or not to call in sick we may be filled with dread knowing once we are well, all our work will be piled up and waiting on us upon our return. We may also stop to consider the negative impact it may have on the people we serve—patients, clients or customers—who count on us to be there when they need us.
The high costs of absenteeism can be easily calculated, but few of us in healthcare have either heard of or considered the higher costs of presenteeism. Presenteeism, which is a largely unknown and foreign concept, is defined as working despite being physically sick, mentally ill, injured, or exhausted.
Presenteeism isn’t just a trait confined to workaholics. Anyone can suffer from this condition but certain professions are at a higher risk. As you might surmise healthcare, teaching and social work are arenas where presenteeism is rampant.
The over-worked, over-extended, over-tired or even ill employee comes to view themselves as indispensable and irreplaceable. No time is given over to self-care. In an attempt to make themselves feel better, it becomes much easier for them to justify the use of mood altering substances or behaviors such as alcohol, illicit drugs, benzos, opioids, gambling or sex because they “deserve it”, “need it to keep going”, or “ I have earned the right.”
Presenteeism is not a sign of wellness. It is a sign of unbalanced life or outright impairment. It can be a front-runner to job related burnout.
Other causes of presenteeism include:
- Workaholism – as already mentioned, working obsessively/compulsively.
- People whose self-esteem is based on work performance.
- Workers who need the money and feel they can’t afford to take time off from work, even when sick.
- A workplace where presenteeism is expected or rewarded.
- High physical workloads or stress levels.
- Poor diet and lack of exercise.
- Low emotional fulfillment.
- Unbalanced living.
In my profession, medicine, I have noticed as good as physicians are at caring for others, as a group they are terrible at taking care of themselves. Many providers, and the people they serve, will watch as their own vitality slowly dissipates and overall health deteriorates, never taking the time to seek treatment or allowing themselves to heal properly following an illness or injury. It is no different for any other worker in a different profession who exhibits the traits of presenteeism.
There are many reasons for this. Even today, with all of our knowledge concerning mental health issues and addictions as treatable illnesses, shame, guilt and stigma still play a part in employees’ decision to avoiding seeking help. As a result, too many workers choose suffering in silence over self-care.
There are studies which show presenteeism costs businesses more than absenteeism due to lost productivity when employees work sick, injured or exhausted which inevitably leads to:
- Deterioration in mental health, physical health, and their abilities.
- Increases risk to patients, customers, or clients due to infection, injury or errors.
- Increase risk to other employees due to injuries or the spread of infection.
Are you suffering from presenteeism? There is a simple way to find out. Answer the following 9 questions and check all that apply:
- Do you often work sick?
- Have you worked while injured?
- Have you presented for work exhausted when you should have taken a day off to rest?
- Are you hesitant to take time off to go to the doctor?
- Do you feel compelled by your employer to work while sick or injured?
- Do you feel your self-worth is tied to your job?
- Do you obsess over work or feel compelled to work, even when you are away from work?
- Do you avoid taking sick days due to loss of wages?
- Do you choose over taking proper care of yourself or attending to your needs—proper diet, exercise, adequate rest?
If you answered to the affirmative to two of these questions you may have, or may be developing, presenteeism. If you answered to the affirmative to three or more of these questions then you definitely have a problem with presenteeism.
If you would like to avoid the progressive and damaging effects of presenteeism then a course change is in order. The remedies for this are numerous and varied. At the outset, the most basic decision you can make to combat presenteeism is to avoid working sick, injured or exhausted.
If you do not have a primary care physician then obtain one and see them as needed and when recommended. This is especially true for providers who should never try to be their own physician.
Sir William Osler, the father of modern medicine, famously said, “The doctor who treats himself has a fool for a patient.” For emphasis I added, “The physician who treats himself has an idiot for a doctor as well as a fool for a patient.” You can never be objective when you are in fact the object.
Do you exhibit the characteristics of presenteeism? Do you have a physician that you see regularly? If not, why not? If you have questions, do not hesitate to contact me directly through the link below.
I am a retired LCSW therapist case managing my difficult elderly mother two states away–my final “client.” My mother probably has a severe Cluster B personality disorder, but has never been formally diagnosed. I just discovered the term “presenteeism” in the last two days and I think “presenteeism” may be intertwined with her behavior as a 1960’s / 70’s stay-at-home mom–one who contracted rheumatoid arthritis at 12 and grew up in dire poverty. My mother did not learn to drive until awhile after I (oldest of three) got my driver’s license at 16. We then-kids were good at walking places and catching rides with other families, as well as being independent early in other ways. My housewife mom was there almost all the time at home, but rarely truly present. Just curious if anybody is writing about presenteeism of housewives (or househusbands) who are performing sub-optimally in this “there-but-not-really”-there attitude with children, rather than at a structured job. Or maybe this is just called garden variety depression / neglect, etc.
Dear P. Web:
Sounds like you’ve had a difficult time of it growing up. It is interesting you became a therapist, someone who helps people with mental health issues. I wonder, if your childhood had been different, better, would have become a therapist? Life is challenging and it sounds like you have had your share. I hope you have found the capacity to see how overcoming those challenges have helped you.
No, I have not yet considered writing about presenteeism from the perspective of housewives, househusbands, or head of households who are performing sub-optimally. I also grew up with a mentally ill parent, my mother. That sounds like it would be an interesting topic for both of us to explore.
I appreciate your comments. Thanks for all you do. Always nice to connect with a reader!
Clark