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Presenteeism hurts productivity

A conversation with Gary JOHNS and Gina RIZZO

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Gary Johns and Gina Rizzo


Why do employees with acute, chronic or episodic illness work rather than stay home?

Gary Johns, a management professor in Concordia’s John Molson School of Business, has been conducting research on presenteeism – the decision to go to work despite feeling unwell.

Although there are no Canadian figures, an American study estimated the cost of presenteeism at $150 billion each year.

To work or not to work

Johns’s research determines the social, physical, psychological and workplace factors that get some employees out the door while others snuggle under the covers when they are sick. To date, this subject has been addressed primarily by medical researchers establishing which illnesses most frequently lead to presenteeism and if certain medications can reduce the potential loss of productivity.

Johns is among the few researchers to apply organizational psychology to the question and consider a range of work-related factors that might affect presenteeism.

As part of his study, he surveyed 444 people on their job requirements and work experience. They were questioned about their attitudes and behaviours, as well as their workplace role and their office culture.

When asked to report on the previous six months, participants reported an average of three presenteeism days and an average of 1.8 absenteeism days, most of which were attributed to illness. Johns’s analysis helped determine how presenteeism impacts workplace productivity.

Caregivers and people working in early education, for example, report higher rates of presenteeism compared to people from other fields. “Often, a person might feel socially obligated to attend work despite illness, while other employees feel organizational pressure to work despite medical discomfort,” says Johns.

Despite the frequency of presenteeism, most human resources departments have not addressed the issue directly, says Johns. He believes that better understanding the issue will improve both office morale and productivity. In most instances, managerial flexibility in decision-making is key.

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In conversation — Beyond the headlines

Presenteeism is rarely discussed, except when infection rates are high (for instance during flu epidemics). However, beyond the risk of infecting others, what are the implications for individuals and their co-workers who continue to go in to work?

This was a question that human resources executive Gina Rizzo considered when she reflected on the results of Johns’s research. Rizzo had an ‘aha’ moment. “We’ve lived this forever. We’ve never talked about it. It’s not something that organizations, at least not in my experience, necessarily have a plan to deal with.”

Most workplaces have policies outlining the terms and conditions required for sick days, personal days and leaves for family responsibilities. It is far more difficult to assess the potential productivity gains of managing presenteeism.

Johns and Rizzo sat down to discuss the importance of getting managers on board. “I think the onus at some point needs to be on leadership and on the management practices,” says Rizzo. “So how do we make managers aware that this is a problem?”

Everybody’s done it

RIZZO: As a manager, I know at times I just didn’t feel like going in for whatever reason. You know there were things happening at home, an ill mother, a child not well, yet I was there. That may be a way to introduce the topic of presenteeism in organizations that are perhaps not even aware of what it is.

JOHNS : One of the nice things about researching absenteeism-presenteeism, is that everybody’s done it … One of my goals in doing this research is to bring this subject, that’s mainly been studied in occupational medicine — trying to find how much productivity is lost due to asthma, due to allergies, due to depression — into mainstream management, and organizational behaviour research.

The pressure to perform

RIZZO: I’m asthmatic, and I can tell you I’ve lost very few days of work because I think there’s also this cowboy attitude that you find in the workplace. It’s not gender specific —you’ll find it in males, you’ll find it in females — that basically says, “I’ve got to show that I’m committed to the organization.”

JOHNS: There’s been a bit of research that also suggests that men are particularly prone to toughing it out. And this is an act of loyalty… a sign of commitment, whether you’re a man or a woman, to the organization.

Some research has shown that if people continue to go to work ill, this is a precursor to absenteeism. So sometimes an occasional absentee day can serve as kind of a safety valve. Get you back together.

Job type impacts presenteeism

JOHNS: People who perceived their jobs as being significant in terms of direct, immediate impact on others, were less likely to be absent. People who are involved in jobs that had a lot of interdependence — teamwork, project work — these people were also very inclined to engage in presenteeism.

RIZZO: Absolutely, if we think of nurses, for instance, we know that there’s a shortage, there’s a shortage of pharmacists, there’s a shortage of other health care professionals. If you know that there’s nobody that’ll replace you, well your professional conscience says what? I need to go in.

Policy and employee wellness programs

JOHNS: I don’t know of any organization that’s developed firm policies or guidelines for managers. We’re firmly in the domain of illness when we talk about presenteeism. And organizations may be disinclined to have managers probing employees about their health.

RIZZO: As far as I’m concerned, there’s a link between your place of work and the health of your employees at work, and job satisfaction, or job productivity. I know that a lot of other health care organizations are talking about instituting wellness programs.

JOHNS: I think these more holistic HR approaches to wellness are going to open the door to allow us to talk about these more specific details. Because it’s not so much a matter of you’re going to work ill; it’s a matter of how healthy are you on any given day.

Watch the video here:

Gary Johns


A Fellow of the Academy of Management since 2010, Gary Johns is a professor and the Concordia University Research Chair in Management at the John Molson School of Business. He earned the 2012 Canadian Society for Industrial and Organizational Psychology Award for distinguished contributions to the field.

Johns came to Montreal in the early 1970s with a solid background in organizational psychology and a PhD from Michigan’s Wayne State University. He joined the university’s faculty shortly after Sir George Williams University and Loyola College merged to form Concordia, and has remained ever since, with the exception of visiting professorships in Australia, Hong Kong and Singapore.

His research has been funded by the Social Sciences and Humanities Research Council of Canada and Quebec’s Fonds pour la Formation de chercheurs et l’aide à la recherche.

Gina Rizzo


Gina Rizzo has been with the Human Resources Department of the McGill University Health Centre (MUHC) for the past 14 years and is currently a human resources (HR) manager and assistant to the MUHC director of human resources. She joined the HR management team in 2006, after seven years as a recruitment specialist.

Her mandate to improve employee retention culminated when she won the AQESSS (Association québécoise d’établissements de santé et de services sociaux) award for Best HR Innovation across Quebec health care organizations for inaugurating the first MUHC Director General Awards and Gala.

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