16-18A Presenteeism


Synopsis: Presenteeism is when people go to work at less than peak efficiency due to illness, injury or distraction. Experts discuss the huge cost to the economy, the chronic illnesses that exact the most cost, and the accommodations that could save businesses billions of dollars.

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Host: Reed Pence. Guests: Rob Hosking, Executive Director, Office Team staffing service; Todd Whitthorne, President, ACAP Health; Michael Klachevsky, Practice Consultant for Absence Management, Standard Insurance Co.

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14-23 Presenteeism

Reed Pence: We’ve all had days when we’re too sick to go to work. Maybe we’ve got the flu and can’t keep any food down at all. Maybe we have a dreadful cold or a migraine and we know that if we went to work, we’d simply sit there feeling miserable, not getting anything done at all. So we stay home in bed. But then there are other days when we don’t feel quite like death warmed over. We’re sick and we still feel miserable but we go to work anyway.

Rob Hosking: From a worker’s perspective, 43% indicated that they very frequently go into work when they’re not feeling well or when they’re feeling sick. Another 20% said somewhat frequently that they would do that, so well over half of the people that responded indicated that they actually would go into work or go in frequently when ill.

Pence: That’s Rob Hosking, Executive Director of the Staffing Service “Office Team,” which conducted a nationwide survey into what’s called “Presenteeism.” Presenteeism is one step down from absenteeism.

Todd Whitthorne: It’s when employees are coming to work and they’re not getting much done. They’re there but they’re not really there. And generally, it will fall into two buckets, what leads to presenteeism: one will be illness, they just don’t feel very good. The other bucket would then be distractions, things like Facebook, things like the smartphone and technology can be very, very distracting.

Pence: Todd Whitthorne is president of ACAP Health in Dallas.

Whitthorne: Most folks when they’re deathly ill and they can’t get out of bed are not going to come to work but what about that area when they’re still infectious and they probably don’t feel very well and they’re most likely not going to get very much done, but they still come to work. Maybe they’re out of their sick days, maybe they’re afraid that they’re going to lose their job, maybe they just feel guilty that others are going to have to do their workload, but in the long run, that can cause ultimately everybody a great deal of time and money if they’re coming and infecting others. Many companies now don’t even have sick days anymore, they just have an X number of paid days off per year. You get 20 days per year and you can take that for vacation, when it’s out, it’s out and you’re not going to get paid any more than that. If that’s the case, and I’ve run out of my days off, I may not be able to afford to call in sick because I have obviously economic demands.

Hosking: In some cases it’s because they’re fearful that if they don’t go in, you know, they should be there or how sick is too sick? You know, I’m not really feeling well or I’ve had the flu or I had the flu yesterday, am I okay today to go in? And I think that there’s that fear that they might have where if I don’t go in, it’s going to look bad on me or I’ll make a bad impression. You know, other cases it could simply be people feel they don’t have the time to be sick or to be away from the office and so I have to get in, I have deadlines to meet, I need to be there to do the job and then in other cases it could very be, “Well, when my manager’s sick, they’re in anyway” or “They’re always there and I need to do that.” And then I think finally, there’s the issue of people feeling as though they can’t take the time away or it will be held against them as it relates to their vacation time. So, “If I’m away today, that’s one less vacation day I get or may have.”

Pence: Some groups are much more likely than others to go to work when they’re sick. For example, the office team survey found that 88 percent of 35 to 44 year olds admit to it. Some jobs are also likely to have a lot of presenteeism. Whitthorne says flight attendants are one such group. But any company may have more than its share of people showing up sick if it’s got a leader with an attitude.

Whitthorne: The vast majority of companies in our country are small. There’s certainly less than 100 employees from a numbers standpoint and so that generally is going to be a reflections of the man or the woman that sits in the corner office or that signs the paychecks. What is their philosophy? Do they encourage folks to work to the bone and to be there bright and early and stay as late as possible? Is that the culture? Or is it a culture that gives a little more permission and a little more flexibility to the employees that they make a decision. “If you’re not feeling great, do yourself and do everyone else in our organization a favor by not coming in because it won’t benefit you and the odds are you’re going to infect us as well and it’s not going to benefit us.”

Hosking: That whole modeling the behavior if you’re a manager and you decide when you’re ill, you’re not going to go in and people know that. You know, the boss isn’t in today because they’re home sick. It gives everybody else a sigh of relief I think where it’s like, “Okay, that means that actually it’s all right when I am ill, I need to take care of myself.”

Pence: In the long run, letting employees be sick makes them healthier, and that helps the company. But even if a company as a whole supports its employees right to be sick, and makes every effort to keep them well, one single boss can torpedo an entire department. Whitthorne is aware of a good example.

Whitthorne: This is a company that happens to have an incredibly beautiful, robust fitness center and they encourage culturally for all their employees to take advantages of it, it utilize it whether it’s before work, at lunch time, after work. Yet one of their departments, one major department, their technology department, they have a leader that really has a personal feeling that if you’re on the treadmill, that’s time that you could be at your desk working and being productive. It’s very short-sighted from my perspective and I can support that with a lot of data but because of the leadership and because of the culture of that particular division, those folks don’t feel as comfortable, they’re not given the permission that other divisions are, to go utilize the facilities that have been built specifically for them.

Pence: Illnesses like colds and the flu create billions of dollars in wasted time each year. But they actually don’t amount to much compared to chronic illnesses. Experts say ailments like allergies, depression, obesity, diabetes and bad backs cost business much more.

Klachevsky: We’ve all come to work with a cold or the flu and we haven’t felt well and we’ve been slow and maybe we went home early but the people with chronic conditions have these conditions all the time and so they’re working every day with this condition whether it’s manifesting itself strongly or not. Whereas, you know, colds and the flu, you get over it and you get back to your usual self.

Pence: That’s Michael Klachevsky, Practice Consultant for Absence Management at the Standard Insurance Company. He says the cost of presenteeism due to chronic illnesses is difficult to gauge, but it may amount to between seven and 22% of America’s total payroll.

Klachevsky: Presenteeism has only been studied for about the last 10 or 12 years. I mean, the phenomenon of productivity lost at work from chronic conditions is as old as work but the study of it is fairly new, so we know a bit less about it, it’s a little harder to quantify. We have some studies that show that the cost to American businesses can be about $150 billion a year in lost productivity, there are all kind of studies that are done that show these big scary numbers. For example, there was one study done to show that for 29,000 workers studied, 66% of lost time was due to presenteeism as opposed to absenteeism.

Pence: Workers who are in constant pain or who are distracted by their illnesses day in and day out don’t get nearly as much done as people who are healthy. Klachevsky says people in chronic pain from headaches and back pain lose 13% of their productivity on average. Irritable bowel syndrome costs 15% of productivity. And when someone’s suffering through allergy season, they may lose 2.3 hours of work time per day. And those kind of illnesses add up to an enormous dollar loss.

Klachevsky: There are studies that have demonstrated that mental health conditions can result in 9.6 lost days per employee per year. There’s other studies that have demonstrated 7.5 lost days per employee per year. Now, you have to multiply these numbers by the total number of employees in the company, not just the ones who have mental health conditions, so these are big numbers. Arthritis, there’s another study that shows arthritis costing the average employer $252 roughly for every employee that they have, even though they don’t all have arthritis, this is what it averages out to. Obesity, for example, one study shows that it costs about 1.8% of payroll in lost productivity and another study showed that our employers spend $506 on lost productivity for every obese employee more than they spend on lost productivity on employees that are not obese.

Pence: The costs from mental illness are likely even more than experts know because few people talk about them. And they strike some professions more than others.

Klachevsky: Depression and anxiety are really very big factors here because they’re pretty hard to spot and people don’t disclose, and not very many people actually get treated for these things, so they end up at work with anxiety or depression over long periods of time. The types of industries where you see a lot of depression for example is public education, teachers, universities, hospitals. When it comes to pain and musculoskeletal problems, of course you see this a lot in the more physical occupations like in manufacturing and construction and transportation.

Pence: Klachevsky says people who work in call centers are also prone to anxiety and depression. And often it’s the employer’s fault.

Klachevsky: Part of that is because of the way that their jobs are designed, they’re very stressful and people have to be on the phones all the time and they’re watched very carefully, so these kinds of folks are probably going to be affected more by anxiety and depression than somebody for example, who’s a truck driver. Who is driving along and it doesn’t really affect his or her performance.

Pence: Employers can either make or break productivity if a worker has a chronic health condition. Again, it’s all about the boss’s attitude.

Klachevsky: I know of one individual, it’s a 26 year old woman who has a herniated disk and she works for a company where there is not one single physical accommodation for anybody. In other words, there’s 400 employees and there are no sit-stand desks. A sit-stand desk would help this woman immensely, in other words so she could sit part of the time and then raise her desk up so she could stand to work. Instead what happens is she sits all day and then she has to get up and walk around and stretch because of her herniated disk. And she’s losing production because she can’t sit at her desk all day, she has to move around. She probably loses about an hour a day as a result of this. If you add that up, spending $400 on a sit-stand desk doesn’t seem very expensive when you think about the productivity loss this young woman is experiencing.

Pence: Businesses don’t see the money they’re losing when workers aren’t as productive as they could be. They may think only of the bill they get when they accommodate chronic conditions. But Klachevsky says companies would be much better off paying to accommodate and reap the rewards later. But if a company doesn’t realize that, Klachevsky says workers with chronic conditions should go ahead and ask for an accommodation.

Klachevsky: So for example, if you have a sore back and you have to get up and walk around all the time, you can ask your employer for an accommodation, a sit-stand desk or a chair, even if the employer doesn’t usually do that because now we have the Americans with Disability Act which does permit, or does require, employers to acquire accommodations for qualifying employees.

Pence: So in the long run, the amount of money companies lose on presenteeism doesn’t really depend on the employees who are sick or hurt or have some condition that slows them down. It’s up to their bosses. And bosses need to ask themselves a few questions.

Whitthorne: What’s your culture about? How do you feel your role is as in health care? Is it just to potentially pay X% of health insurance or do you have a role in creating and leading a culture or environment of wellness that can really measurably improve health in your population and we know that when we can get people healthier, they’re going to feel better, they’ll get more done, they don’t call in sick as often, and they’re more likely to rise in the ranks of the organization.

Pence: You can find out more about all of our guests on our website… radiohealthjournal.net.

I’m Reed Pence.

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