Do You Suffer from Presenteeism—Here are 9 Signs to Know

Did you know presenteeism is more costly to an individual and organizations than absenteeism?

Most of us know firsthand the loss of productivity and impact that absenteeism has in the workplace.
What of presenteeism?

Most of us know firsthand the loss of productivity and impact that absenteeism has in the workplace. It is not a completely unknown or foreign concept. When we take time out of work for being sick we may actually feel guilty for being absent knowing the burden it will place on someone else who will have to do the work in our stead. We know this from experience. When one of our coworkers is out sick, we are the one onto which their responsibilities fall, the one who is asked to do their work until they return.

Alternatively, in considering whether or not to call in sick we may be filled with dread knowing once we are well, all our work will be piled up and waiting on us upon our return. We may also stop to consider the negative impact it may have on the people we serve—patients, clients or customers—who count on us to be there when they need us.

The high costs of absenteeism can be easily calculated, but few of us in healthcare have either heard of or considered the higher costs of presenteeism. Presenteeism, which is a largely unknown and foreign concept, is defined as working despite being physically sick, mentally ill, injured, or exhausted. 

Transcript of Video #5 – Job Related Burnout Can Be Mitigated, Alleviated or Eliminated

This is the fifth video in this series on job related burnout. In the last video, I discussed the 6 major mismatches between the job and the employee which will lead to burnout. In this video, I will begin to give you some information on how to mitigate, alleviate and eliminate those 6 mismatches.

If you will recall from the last video, the 6 job mismatches are work overload, lack of control, absence of fairness, breakdown of community, insufficient reward and conflicting values. These mismatches can occur singly or in any combination to varying degrees.

However, they must each be addressed individually as each will have a unique set of solutions. Failure to address these mismatches can result in a dysfunctional and burned out staff with high staff turnover and inferior products or services, the costs of which are extremely high.

Mitigating, alleviating and eliminating the 6 job mismatches which lead to burnout and creating an engaged workforce is a process. There are two approaches, both of which must be employed – the individual approach and the organizational approach.

The individual approach begins by assessing the degree to which individual employees are burned out. This is best accomplished by applying the Maslach Burnout Inventory or MBI.

The MBI is a 25-item questionnaire with both sensitivity and specificity for detecting burnout and has the accuracy needed for measuring the degree of burnout when present. It is the industry gold standard for the measurement of burnout.

The MBI will precisely assess every employee’s work experience on the continuum from engagement to burnout. It will also survey their perceptions of the six arenas of organizational life – workload, control, fairness, community, reward, and values.

Before and after MBI data can then be used to objectively gauge if or how well job mismatch programs and solutions are working following intervention and implementation.

The organizational approach usually requires an on-site assessment of the work environment. This would include application of a different survey instrument – The Staff Survey or Maslach Areas of Work-Life Survey (MAWS). The MAWS provides a picture of the underlying problems an organization is encountering when transitioning through change.

It provides information on three separate work domains – the employee’s personal experience working within an organization, the six arenas of life within an organization where job mismatches can occur and the management of the organizational environment. The results provide a clear overview of how the three work domains connect with each other and how an organization responds to internal and external conflict and change.

All together, an on-site visit plus application of the MBI and MAWS will accurately describe the management and work environments, the six arenas of organizational life and the employee’s perception of their work experience. The result is a solid framework for planning and change, to process the workforce from burnout to engagement.

What employee doesn’t want to feel pride, passion and purpose in their work? What organization doesn’t want an engaged workforce, who’s work is characterized by vigor, dedication and absorption, the hallmarks of ENGAGEMENT!

The payoffs for this are enormous with all upside potential. Fully engaged workforces produce superior products and services, have less employee turnover and absenteeism, fewer customer complaints, higher customer satisfaction, high employee satisfaction, more innovation and creativity. The list of benefits is seemingly endless, all of which improve profit margins and reduce costs.

When you encounter an organization that’s fully engaged you can feel it from the first interaction to the last and it makes you want more of what they are offering and you will tell everyone you know what a great experience you had with them.

If you, as an employee, feel you are burned out at your job, don’t know where to turn or what to do, I can help. Whether your goal is to reengage in your current job or transition to something new which better suits you and your natural set of talents, abilities and values, I can help.

Send an email to me at or leave me a voice message through the link over on the side bar and I will respond. I offer a variety of coaching services to fit your individual needs. You can find more information on this at under the Services/Coaching tab.

If you are an executive or manager and feel your organization’s workplace environment has become toxic and dysfunctional, it may be suffering from the ravages of job related burnout. It doesn’t have to be that way. I can help. I offer a range of consultation services as well as Corporate Resilience Training to mitigate, alleviate and eliminate job related burnout.

Send me a message either by voicemail or the link below and I will get back to you. You can find more information at under the Services/Consulting and Corporate Training tab. If you require further information, have questions, of feel I could be of service to you or your organization, please don’t hesitate to ask.

Follow the link to view this video, Job Related Burnout Can Be Mitigated, Alleviated or Eliminated.

In the next video I will introduce The REIGNITE Framework – a step by step guide of my own design which takes individuals from burned out to on fire by helping them re-balance their lives, recapture the joy and pleasure derived from meaningful work and REIGNITE with a renewed sense of passion and purpose!

As always, thanks for watching.

 Contact Dr. Brunout

Transcript of Video #4 – 6 Job Mismatches Which Cause Employee Burnout

In the last video in this series, I discussed the scope of job burnout and why it matters. In this video, I will discuss the root causes of workplace burnout, the six mismatches between the job and the employee which lead to burnout.

There is a general misconception that an employee burns themselves out. The truth is, 90% of the time it is the job which burns out the employee. You can take an on fire, energetic, dedicated, passionate and purpose driven employee and put them in the wrong work environment and you will burn them out.

When it is recognized that an individual has burnout, that individual often becomes the sole focus of efforts to correct any underlying problems. Burnout symptoms may be incorrectly attributed to stress, anxiety, depression, irritability or ambivalence. These maybe manifestations of burnout but they are not usually the cause of it.

The work environment itself is often ignored. Burnout occurs anytime and anywhere there are major mismatches between the nature of the job and the nature of the person who does the job.

Certainly, a person could choose a profession to which they are not well suited. But, more often than not an individual can find themselves in a job where there is substantial conflict between the demands of the job and their core values. When this occurs the potential for job burnout is high.

In their book, The Truth About Burnout, Christina Maslach and Michael P. Leiter explain the causes of burnout lie more in the job environment than within the individual. They have identified six major mismatches between people and their jobs which, when left unattended to properly, will lead to burnout.

Here are the six major mismatches which contribute to job burnout:

  1. Work Overload. Downsizing, budget cuts, layoffs, reorganization efforts all usually result in three things – more work intensity, more demands on time, more job complexity. In short, people are required to do ever more with less. This can leave individuals exhausted.
  2. Lack of Control. Organizations which become intolerant of creative problem solving in lieu of centralized control will squelch individual autonomy. This reduces an employee’s capacity to set limits, exercise problem solving, select individualized approaches to work, allocate resources and set priorities. The overall effect is a loss of interest in the job and monumental frustration.
  3. Insufficient reward. Market forces focusing on reducing costs have also reduced organizations’ capacity to reward their employees in meaningful ways. People seek tangible rewards from meaningful work such as money, security, recognition, benefits, intrinsic satisfaction, etc. If these are lacking people naturally begin to wonder why they are working so hard. More work + less reward = dissatisfaction.
  4. Breakdown of Community. As organizations grow larger or too quickly a breakdown in the character of the organization can result as short-term profit is chased at the expense of interpersonal relationships within the company. This will inevitably lead to greater conflicts among employees, a lack of mutual support, lack of respect and a growing sense of isolation. Dr. Maslach states, “A sense of belonging disappears when people work separately instead of together.”
  5. Absence of Fairness. Maslach perceives a workplace to be fair when three key elements are provided: trust, openness, and respect. When all three are present employees are valued and they will in turn feel valued and remain fully engaged (the opposite of burnout). When these elements are absent burnout will be the direct end result.
  6. Conflicting Values. If organizations say they are dedicated to excellence service yet take actions which damage the quality of the services they provide then conflict results. This can be extremely frustrating and demoralizing to the employee, especially if their internal moral compass or core values are being assailed. To achieve a quality product or service a company’s values must remain in alignment with those of the employees.

These mismatches can occur in any combination or in aggregate. However, they must each be addressed individually as each will have a unique set of solutions.

Failure to address these mismatches can result in a dysfunctional and burned out staff with high staff turnover and inferior products or services. I don’t have to tell you, the costs of this are devastatingly high, not only for the individual employee but an organization as a whole.

If you feel you or your organization may be suffering from the effects of job related burnout there is much which can be done to mitigate, alleviate, or eliminate these symptoms simply by identifying and addressing these six underlying causes.

Follow the link to view this video, 6 Job Mismatches Which Cause Employee Burnout. In the next video in this series I will be discussing how Job Related Burnout Can Be Mitigated, Alleviated or Eliminated.

In the meantime, if you fill in the box in the upper right hand corner of this page or follow the link directly below the video you can download a FREE 6 Job Mismatches Checklist, and thanks for watching.

Contact Dr. Brunout

Transcript of Video #3 – The Scope of Job Related Burnout and Why It Matters

In this third video in the series on Job Related Burnout, I’ll discuss the scope of the problem and why it matters.

There is a detectable job burnout rate for any profession you can name. Some professions have very low rates of burnout such as hair stylist, audiologist, university professor, medical records technician, jeweler, medical laboratory technician, seamstress, dietician, librarian or forklift operator.

Some of the most stressful jobs with the highest burnout rates include retail, fast food, public accounting, police officer, attorney, school principal, teacher, social worker, nurse and the #1 most stressful job in the country – physician. Just listen to some of the statistics on burnout rates among physicians, an arena in which I am very familiar.

  • In 1987, an AMA survey showed that 44% of physician respondents over the age of 40 would not choose medicine as a career if they had it to do all over again. That number is now closer to 90%.
  • A 2011 survey of 2,069 physicians by Physician Wellness Services, a Minneapolis based company, found 87% of respondents felt moderately or severely stressed or burned out daily. The median age was 45 with an average of 13 years in practice.
  • In a survey that was presented to 13,000 physicians in 2012, 6 out of 10 physicians would quit today if financially able to do so. That’s 60%!
  • A 2012 study of 7288 physicians published in the Archives of Internal Medicine revealed that 46% reported at least one symptom of burnout.
  • Burnout rates approach 70% in some specialties. Specialties with higher than average rates of burnout were Emergency Medicine, Family Medicine, General Internal Medicine, and Neurology.
  • The burnout rate among female physicians at 60% is higher than the male physician burnout rate of 52%.

One thing is certain, if any individual can identify the hallmarks of burnout they are either burning out or burned out. I don’t have to tell you the costs of job related burnout are devastatingly high, not only for the individual employee but the organizations who employ them.

I should know, I became burned out as a family physician. About six years ago I had hit all three hallmarks of burnout which I reviewed in the previous video, Defining Job Related Burnout. I felt horrible. I even felt guilty for feeling the way I felt. I didn’t know exactly what was wrong at the time. I just knew some things had to change.

I would later discover I was suffering from job related burnout and I began to study it in depth. I discovered individuals who become burned out are at risk for poor job performance, chronic unhappiness, increased irritability, depression, anxiety and mood swings. Even suicidal thoughts, suicidal actions, alcoholism and drug abuse are documented consequences of job burnout.

Bottom line, if you are burned out you will never feel you are living a life of purpose with passion. Besides the obvious consequences of these, there is also a potential for a great loss of knowledge, expertise and creativity.

A person’s vitality and creative force will be stymied or destroyed by burnout. Someone’s passion and sense of purpose can be completely subverted. Physicians have quit medicine, CEO’s have left the corporate world and experts in every profession have abandoned their chosen fields of endeavor over job burnout, all of which are tragedies.

For organizations, failure to address burnout in the workplace can result in a dysfunctional workforce, high staff turnover and inferior products or services. The result is a type of internal rot, not to mention the financial devastation this can bring. Replacement costs for workforce talent can carry a huge price tag for any business. In my profession, medicine, it can cost $100,000.00 to 1 million dollars just to replace a single physician.

The great news about burnout is it’s 100% reversible, treatable and preventable. When I realized I was suffering from job burnout I made some very simple changes right away which made all the difference in the way I felt toward myself, my patients and my profession.

I was able to attain the state opposite of burnout – Engagement.

To create a more engaged, productive and stable workforce, organizations can make some very simple changes to eliminate or prevent the six major causes of employee burnout.

In the next video in this series I’ll be discussing the 6 Job Mismatches Which Cause Employee Burnout. Follow the link to this video, The Scope of Job Related Burnout and Why It Matters, and thanks for watching.

 Contact Dr. Brunout

Transcript of Video #2 – Defining Job Related Burnout

In 2009 I went to my practice partner and told him that I either had to make some changes or I was going to have to quit practicing medicine. I told him how I felt – overworked, exhausted, dissatisfied and unappreciated. I no longer felt I was making any difference in the lives of my patients.

I had been reading on the subject of physician burnout and was convinced I aptly fit the definition. So, I put an action plan together for myself and began taking steps to fix what was broken.

These steps I took made all of the difference. I began to enjoy the practice of medicine again. I developed a new patience for my patients. Energy returned. I felt more at peace. I became hopeful for the future again. I began to achieve a more balanced life.

I wondered if others felt the same as me so I studied burnout in depth, its warning signs, symptoms, consequences and treatment. I began to give talks on the subject and they were well received. I found I was not alone. There are staggering numbers of my colleagues and other professionals suffering from job related burnout, just as I was.

The hallmarks of burnout were determined back in the late 70’s and early 80’s through the work of Dr. Christina Maslach. The Maslach Burnout Inventory (MBI) is still the gold standard for objectively measuring burnout in the workplace.

There are three principle hall marks associated with job related burnout. They are emotional exhaustion, depersonalization, and a lack of a sense of personal accomplishment. In varying degree, some combination of these will always be present when someone is burned out at work.

Emotional Exhaustion – It is a feeling of being emotionally depleted to the point where you feel you can no longer give of yourself at an emotional or psychological level to your company or the people you serve. The KEYWORD is Exhaustion.

Depersonalization – The development of negative and cynical feelings leading to a callous and dehumanized perception of patients, clients or customers which further leads to the view that they are somehow deserving of their problems and troubles. The KEYWORD is Cynicism.

Lack of a Sense of Personal Accomplishment – You feel so little reward from what you do there is a tendency to evaluate yourself in negative terms which leads to dissatisfaction and unhappiness in your work creating a lack of a sense of personal accomplishment. The KEYWORD is Inefficacy.

Men and women will register these slightly differently. Women will usually hit all three of these and in the order presented. Men will usually get cynical first followed by emotional exhaustion.

Men may or may not hit the third hallmark of a lack of a sense of personal accomplishment. Most men will feel their work always has some meaning, at least to them. One thing is certain, if an individual can identify the presence of these hallmarks they are either burning out or burned out.

I don’t have to tell you the costs of job related burnout are devastatingly high, not only for the individual employee but the organizations they work for as a whole. We will explore this further in the next video in this series entitled The Scope of Job Burnout and Why It Matters.

If you click on this link, The Three Hallmarks of Burnout, you can download a document page for future reference. Follow the link to view this video, Defining Job Related Burnout, and thanks for watching.

Contact Dr. Brunout