Can there be a worthwhile trade off between work and health? Professors Wladislaw Rivkin, Trinity Business School, Stefan Diestel, University of Wuppertal,  Fabiola H. Gerpott, WHU—Otto Beisheim School of Management, and Dana Unger, The Arctic University of Norway,explore why presenteeism occurs and how to combat it.

By CoBS Editor Pavan Jambai. Related research: Should I Stay or Should I Go? The Role of Daily Presenteeism as an Adaptive Response to Perform at Work Despite Somatic Complaints for Employee Effectiveness, Wladislaw Rivkin, Stefan Diestel, Fabiola H. Gerpott, and Dana Unger; Online First Publication, March 17, 2022. http://dx.doi.org/10.1037/ocp0000322.

The 800-pound gorilla

For most readers, working in a state of ill health may not be an alien event. In fact, most of us are used to and expected to push through with the work, especially when on a deadline. However, not many of us may be aware of the name for this phenomenon – Presenteeism – also referred to as the 800-pound gorilla in the business and corporate world.

The reason it is referred to as such is due to the tremendous costs for employees such as increased burnout, impaired workability, and productivity loss which in turn and most importantly reflects as costs for the organisation.

Beyond the moral obligation of organisations and managers to safeguard the health of their employees, there is also concrete evidence that engaging in and encouraging presenteeism has grave consequences both in the short and long term. So why exactly do some organisations encourage it and employees engage in it?

Obvious but oblivious – why presenteeism occurs

Researchers until now have identified macro-level determinants that are detached from the individual level of the employee. At the job level, work demands such as role demands, long work hours, and time pressure, and at the organisational level, working in the private sector and organisational size are some of the factors that are attributed to presenteeism.

However, this rich understanding does not contribute to the fluctuations within the individual at a personal level. For instance, an employee suffering from chronic health complaints has to engage in presenteeism over the long term to produce a performance that is comparable to that of an employee who is less affected by such complaints.

One of the major determinants of presenteeism, the researchers found, was the amount of work progress in the concerned day. It is indeed understandable that employees would prefer to work even in a state of discomfort when the amount of work is overwhelming and would rather rest when the workload is manageable. 

And as we are socially conditioned throughout our life, it is unsurprising that how others perceive us is also a crucial determinant of presenteeism. In order to answer the dreaded yet pointless question of ‘what would my colleagues and manager think?’, most employees engage in presenteeism especially when the workload is too much to ‘prove their worth’.

Long term phenomenon? Not quite

Irrefutable proofs from various studies have reinforced the fact that the estimated costs of presenteeism potentially exceed those of absenteeism. Presenteeism not only directly impairs the ability to work – making more errors because of the inability to concentrate while working – but can also compromise physical and psychological recovery processes.

For a long time, people in the scientific community assumed that presenteeism is a relatively stable phenomenon that only fluctuates over longer time frames such as months or years. However, recent studies have shown that presenteeism is a dynamic behavior that can fluctuate across shorter time frames such as days.

To illustrate, consider an employee experiencing a headache. After a few hours, the headache may either have gotten worse or better. In both cases, presenteeism is likely to be reduced as either the employee stops working due to a continued prevalence of the health complaint (absenteeism) or continues working as the experience of ill-health has passed.

Presenteeism – the spillover effect

Engaging in presenteeism may help employees in achieving their goal for the day, but more often than not it has a spillover effect. Most human beings have a fixed reserve of self-regulation and self-control for a given period of time. And it is uncommon for an average human to have an infinite amount of willpower.

When engaging in presenteeism employees are forced to reach deep into the reserve of self-regulation and deplete most of their resources. They use the resources to refrain from focusing on and/or distracting from ailments and tending to their complaints by taking breaks or contacting the doctor.

What follows this day of self-regulation and suffering is usual absenteeism or a day of mediocre productivity since presenteeism usually spills over to the next working day. Even though the recovery process might happen between these days, especially during sleeping hours, it is seldom complete and effective.

It is saddening that employees may find these findings eye-opening. Often when they think there is a trade-off between taking care of themselves and being efficient, there is no trade-off at all: when ill, protecting and preserving their health today means avoiding negative work-related consequences tomorrow.

Bad manager = Bad culture = Bad company

Any employee would swear by this: Employees leave (bad) managers, not (bad) companies. Since they have the front seat view to an employee’s working state, managers are the ones who can help as well as further hurt the employees when they engage in presenteeism.

Managers should be vigilant about this since not all somatic complaints are visible and apparent. They can offer targeted support to employees who feel unwell by giving positive feedback about their achievements. They can also instruct an employee to stop working if it becomes evident that they are engaging in presenteeism.

Managers can also highlight that presenteeism is not rewarded but in fact, disapproved. This is usually achieved through flagging presenteeism behaviour when an employee engages in it as well as walking the talk and setting example themselves by not engaging in presenteeism.

In reality, however, the hands of the manager are usually tied, having to abide by company policy and rules. In this case, managers can encourage employees to only work on inherently enjoyable work tasks when engaging in presenteeism. As they say, where there is a will, there is a way.

Employees as family

The COVID-19 pandemic, despite the tragic losses it caused, came as a blessing in disguise for employees who had little to no control over their presenteeism behaviour. The flexibility to work from home, which is now likely to be a permanent feature of the corporate world, has more or less effectively addressed the problem of presenteeism.

However, to have a real and sustainable change, there needs to be mutual acknowledgment between employees and management (including managers) that this is a real issue. On their side, employees should be encouraged to speak up about their problems and rights to avoid adverse effects on their health – which in turn affects the companies’ productivity.

In a nutshell, management would do wise to treat their employees as family, especially in the current complex and challenging situation and age. Various reports state that employees are increasingly seeing work as a means to live their lives and not the other way around. And if the job does not offer flexibility, purpose, and compassionate leadership, companies might find it difficult to attract and retain employees in the not so far future.

Useful links:

• Link up with Wladislaw Rivkin, Stefan Diestel, Fabiola H. Gerpott, and Dana Unger on LinkedIn.
• Read a related article: The impact of long working hours on employees
• Discover Trinity Business School, Trinity College Dublin
• Study at Trinity.

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