Clinton presenteeism

The presenteeism problem: The real lesson behind Clinton’s illness

By Alyssa Hurst

On Sunday, Hillary Clinton left a 9/11 memorial in Manhattan early due to a combination of heat exhaustion and pneumonia. Video of her exit shows a wobbly Clinton stumble into a vehicle before heading to daughter Chelsea’s apartment in the city to recover. Despite a pneumonia diagnosis, and doctor’s orders to rest, Clinton pressed on in her pursuit of the presidency. The incident sparked plenty of conversation about Clinton’s ability to lead the country, but it also drew attention to the issue of presenteeism in the workplace.

According to Clinton’s personal doctor, Dr. Lisa R. Bardack, M.D., Clinton had been dealing with a cough related to allergies, which eventually turned into pneumonia. That pneumonia diagnosis came two days before the memorial, and in the two days that followed, Clinton cancelled events in California to spend Monday and Tuesday recovering.

Yet despite the severity of her condition, and her doctor’s advice, Clinton didn’t share her diagnosis with her whole team, many of whom had been battling similar respiratory issues, and chose to stick to her demanding schedule. The Economist reports that Clinton likely felt pressure to be present, as her illness “comes at a perilous time for her campaign, with recent polls suggesting her once-ample lead over Mr. Trump has shriveled to around three percentage points. … Making matters worse, conspiracy theories have long circulated among her enemies on the right about the supposedly poor state of her health.”

But, pressure to show up at work when battling illness is not unique to presidential candidates, reports The Huffington Post: “Working while sick is a widespread American phenomenon, ingrained in our public policy and embedded in our workaholic, and often male-dominated, office culture.”

Harvard Business Review calls this workplace issue “presenteeism”: “The problem of workers’ being on the job but, because of illness or other medical conditions, not fully functioning.” And, the Review reports, by showing up to work sick, employees may be cutting productivity by one-third or more. “In fact, presenteeism appears to be a much costlier problem than its productivity-reducing counterpart, absenteeism,” says Harvard Business Review. Not only do sick employees get a lot less work done at a lower quality, but they also run the risk of infecting others and thus leading to even more detrimental effects on productivity.

This problem comes largely as a result of a culture that rewards those who are willing to tough it out. “We praise workers who never take sick days, like a UK train dispatcher who didn’t use one in 66 years,” reports Quartz.

Cultural norms aside, Bloomberg reports that many people show up to the office despite illness because of financial pressures, and that nearly one-third of American workers do not have access to paid sick leave. What’s more, 50 percent of workers say they worry that work will pile up if they stay home.

In the face of rising healthcare costs and the potential lack of productivity that comes with encouraging sick employees to make an appearance in the office, what can you as a leader do?

  • Reduce financial pressures. “The cities that adopted paid sick-leave mandates … saw flu cases drop by about 5 percent after their laws took effect.” And, according to a working paper by the nonprofit National Bureau of Economic Research, fewer people get sick when those that are ill don’t have a financial incentive to show up to work.
  • Educate employees on their risks and resources. “You may want to set up programs to ensure that illnesses aren’t going undiagnosed because employees don’t realize they have a problem. … It’s also helpful to teach employees how to better manage their illnesses,” advises Harvard Business Review. The review cited International Truck and Engine, which offered employees free consultations with an allergy specialist, which helped several employees find helpful treatments.
  • Pay for new and better medical treatments for employees. Harvard Business Review points to flu shots as the “poster child” for this approach. “Numerous studies have shown that the cost of offering free shots is far outweighed by the savings realized through reductions in both absenteeism and presenteeism.”
  • Offer work-from-home options. “Diligent workers who absolutely must meet a deadline or finish a life-or-death project should at least self-quarantine,” says More than 60 percent of employers allow employees to work from home, as telecommuting has become a more acceptable way to work.

Alyssa Hurst is the associate editor of SmartCEO magazine and Contact her at