Presenteeism: A Public Health Hazard

Abstract

"Presenteeism" occurs when an employee goes to work despite a medical illness that will prevent him or her from fully functioning at work. This problem has been well studied in the business and social science literature, and carries increased importance in the health care setting due to the risk of infectious disease transmission in vulnerable patient populations. In this manuscript, we discuss an outbreak of viral gastroenteritis in a long-term care facility and the role presenteeism played in disease transmission and extension of the outbreak. We use existing literature to point out the hazards of presenteeism in the health care sector. We will also discuss factors that may be involved in the decision to work while ill and propose policy changes that may reduce the incidence of presenteeism in health care organizations.

Paid Sick Leave as a Means to Reduce Sickness Presenteeism Among Physicians

“…Presenteeism has been associated with negative personal outcomes, such as decreased general health (Aronsson et al, 2011;Bergström et al, 2009), depression (Conway et al, 2014), burnout (Miraglia & Johns, 2015;Thun et al, 2014), and future sickness absenteeism (Bergström et al, 2009;Gustafsson & Marklund, 2011;Hansen & Andersen, 2009), and with negative organizational outcomes such as decreased performance and productivity (Dellve et al, 2011;Hemp, 2004;Schultz et al, 2009). Presenteeism has also been identified as a risk factor for committing serious errors and safety violations (Niven & Ciborowska, 2015), and in disease transmission (Widera et al, 2010). To limit presenteeism's role as a health hazard (Widera et al, 2010) and to promote health among physicians and their patients, it is vital to investigate initiatives to decrease this behavior among physicians.…”

“…Presenteeism has also been identified as a risk factor for committing serious errors and safety violations (Niven & Ciborowska, 2015), and in disease transmission (Widera et al, 2010). To limit presenteeism's role as a health hazard (Widera et al, 2010) and to promote health among physicians and their patients, it is vital to investigate initiatives to decrease this behavior among physicians.…”

Presenteeism: Are We Hurting the Patients We are Trying to Help?

“…In their case report, healthcare professionals returned to work ill despite increasing evidence that their behaviors were perpetuating the outbreak. Decisions were made to circumnavigate policies enacted to curb the transmission of an identified infectious pathogen 3 . Why would healthcare providers report to work ill and risk disease transmission to their patients in light of this information?…”

“…Why would healthcare providers report to work ill and risk disease transmission to their patients in light of this information? The reasons cited by Widera et al are varied and may depend on where the healthcare worker resides in the chain of command 3 . Nonetheless, meaningful change should begin with the physicians as the standard for other healthcare workers.…”

“…Second, they advocate for systematic processes that screen individuals for communicable diseases especially during disease outbreaks. Lastly, adequate staffing must be appropriated to avoid the often incorrect feeling that "my patients are better off with me there sick than if I am not there" mentality 3 .…”