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  • Dr. Brian Kleinberg

Are You Present or Absent at Work?


Tina (not her real name) goes to work every day, so to speak. Physically she is present. But in so many ways she is absent. Tina has chronic neck pain as well as tingling and pain from her right forearm to her fingertips. She is suffering all the time. She tells me this disrupts her work and makes it difficult for her to get things done on her computer. She also has aging parents who she is constantly taking care of. She has a son who has learning issues and is not focused in school. Finances are strained and her marriage is in decline. Tina has a lot of mental stress and it gets in the way of so much of what she does every day. She tries to put on a good face and she rarely takes off time because she is dedicated to her company and her work. She is extremely private and avoids talking about her concerns with co-workers or managers. Tina is suffering from presenteeism.


What is presenteeism? And how does it differ from absenteeism? With absenteeism a person is not physically at work due to injury or illness. Physical and mental health issues are the most common reasons why people are absent from work for brief or extended periods. Absenteeism usually describes a pattern in which people are habitually away from work although the term can also include people who have planned absenteeism which can include time off and sabbaticals. With absenteeism the company has awareness of the situation and can take steps to temporarily replace that person at work. Although the impact of absenteeism can be highly significant for certain companies, the financial effect can be measured, and the company can try to address the concern through health and safety activities where applicable.


Presenteeism describes a situation in which a person comes to work but due to physical and mental strain they are far less productive than they could be. Usually these individuals do not want to go on short-term or long-term disability. They don't want to complain and so they continue to work and show up dutifully every day even though they are suffering on multiple levels. In many cases they don’t tell co-workers that they are suffering. They keep it under the radar as they don't want to be scrutinized by their employer. These people suffer in silence and Tina is one of them. Her story is not uncommon. It's a story I frequently hear in my professional practice, corporate workshops and at health coaching sessions. People bring multiple personal concerns to their workplace every day. Breathtaking technical changes, downsized companies and stressful work environments, as well as personal health issues are increasing the physical, mental and emotional demands of modern day workers.


Aside from the difficult human factors which are affected by presenteeism, there are economic costs as well. Studies have shown the significant impact on companies from absenteeism due to lost time and reduced productivity. What's most surprising is the cost of presenteeism is significantly higher than the financial impact of absenteeism. Most companies are not taking active steps to address this concern and both employers and employees are suffering the consequences. What can be done to address this widespread concern?


Employer Steps:



  • First of all, recognize that there is a problem. There is an unprecedented amount of physical and mental stress in the workplace today notwithstanding that most jobs are sedentary. In fact, being sedentary at work is contributing to more chronic pain than jobs that are more physically active. Mental health issues are probably more pervasive due to the myriad responsibilities that people are taking upon themselves, especially middle-aged employees in the aging demographic, often called the sandwich generation.

  • Develop better communication with your employees. Newsletters, text messages and frequent reminders will show your employees that you care about them and are interested in their well-being. Your company should have a wellness strategy and at least one individual who is responsible for constantly implementing innovative programs and new ideas.

  • As a result of better communication, focus on building rapport, improved morale and aim for employee retention. Consider inviting employees to brainstorming sessions on health and wellness strategies. An anonymous health and wellness survey will give your company the pulse of how people are currently doing physically, mentally, financially and socially. People who are suffering with presenteeism will not come forward without feeling comfortable that the company genuinely cares about each person and values their contribution, not to mention guarding their private concerns.

  • EAP’s, extended health care insurance for paramedical services and sick-leave benefits should be carefully reviewed and improved so employees will feel comfortable and financially covered in case they require this help. These benefits should be clearly explained and well known to all employees. People should not be afraid to utilize these services/benefits or feel that they may be penalized for utilizing them.

  • Corporate health and wellness programs including workshops, seminars and health coaching can have a significant impact on the well-being of your employee population. Create a culture of wellness and your employees will not hesitate to come forward to discuss their concerns and make your workplace more functional and productive.

Employee steps:



  • Suffering in silence at work for any reason should not be an option for you. You are only harming yourself by not seeking out the help that you need for the concerns that you have. If services and benefits are available to you, please take advantage of them.

  • By pretending that everything is okay with you when it's not, you are harming your own ability to be productive and make a full contribution to your workplace. You are denying your employer and the company the best of your abilities. It is a lose-lose situation and it can only get worse as time goes on. You must feel that you can open up to your employer.

  • Seek help for your physical, mental, emotional, social and financial concerns. You will come to work with renewed energy and vitality and your company will benefit from a more productive, engaged employee. You owe it to yourself and your employer to be honest about your needs and your obligation to take care of yourself.

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