Featuring scholarly and practitioner insights from HR and people leaders, industry experts, and researchers.

Sickness presenteeism, the practice of attending work while ill, is driven largely by organizational systems rather than personal choice. Studies demonstrate that punitive attendance policies and insufficient paid sick leave heavily pressure vulnerable and hourly employees to labor through contagious or debilitating conditions. Furthermore, working while sick results in severe organizational consequences, including widespread illness outbreaks among customers and colleagues, diminished long-term individual wellbeing, and hidden productivity losses that exceed traditional absence costs. To combat these issues, leaders must implement evidence-based solutions such as decoupling discipline from medical leave, establishing sufficient staffing slack, and modeling healthy recovery norms from the top down. Ultimately, organizations that prioritize sustainable recovery capability can protect public health, enhance workforce trust, and maintain reliable performance over time.

Sickness presenteeism, the practice of attending work while ill, is driven largely by organizational systems rather than personal choice. Studies demonstrate that punitive attendance policies and insufficient paid sick leave heavily pressure vulnerable and hourly employees to labor through contagious or debilitating conditions. Furthermore, working while sick results in severe organizational consequences, including widespread illness outbreaks among customers and colleagues, diminished long-term individual wellbeing, and hidden productivity losses that exceed traditional absence costs. To combat these issues, leaders must implement evidence-based solutions such as decoupling discipline from medical leave, establishing sufficient staffing slack, and modeling healthy recovery norms from the top down. Ultimately, organizations that prioritize sustainable recovery capability can protect public health, enhance workforce trust, and maintain reliable performance over time.

Sickness presenteeism, the practice of attending work while ill, is driven largely by organizational systems rather than personal choice. Studies demonstrate that punitive attendance policies and insufficient paid sick leave heavily pressure vulnerable and hourly employees to labor through contagious or debilitating conditions. Furthermore, working while sick results in severe organizational consequences, including widespread illness outbreaks among customers and colleagues, diminished long-term individual wellbeing, and hidden productivity losses that exceed traditional absence costs. To combat these issues, leaders must implement evidence-based solutions such as decoupling discipline from medical leave, establishing sufficient staffing slack, and modeling healthy recovery norms from the top down. Ultimately, organizations that prioritize sustainable recovery capability can protect public health, enhance workforce trust, and maintain reliable performance over time.

Sickness presenteeism, the practice of attending work while ill, is driven largely by organizational systems rather than personal choice. Studies demonstrate that punitive attendance policies and insufficient paid sick leave heavily pressure vulnerable and hourly employees to labor through contagious or debilitating conditions. Furthermore, working while sick results in severe organizational consequences, including widespread illness outbreaks among customers and colleagues, diminished long-term individual wellbeing, and hidden productivity losses that exceed traditional absence costs. To combat these issues, leaders must implement evidence-based solutions such as decoupling discipline from medical leave, establishing sufficient staffing slack, and modeling healthy recovery norms from the top down. Ultimately, organizations that prioritize sustainable recovery capability can protect public health, enhance workforce trust, and maintain reliable performance over time.

In this HCI Webinar, I talk with John Dorer about how employer-sponsored immigration fits into broader workforce planning. As the CEO of eb3.work, John Dorer leads a team of immigration attorneys and recruiters who specialize in providing effective solutions for employer sponsored green card programs and entry-level labor shortage. With over 23 years of experience, they have extensive knowledge and expertise in the field of global mobility and the EB-3 visa program. Our mission is to partner with employers to help them eliminate their chronic entry-level labor shortages. Their team of recruiters and immigration attorneys leverage proprietary technology and processes to streamline the EB-3 application and approval process, and to ensure compliance and quality. They work with employers across various industries and regions, including construction, manufacturing, hospitality, QSR, janitorial services, multi-unit restaurant franchise groups, warehouses, and distribution centers. They are passionate about creating opportunities for both employers and workers, and contributing to the economic and social development of the country.

Abstract: Sickness presenteeism, the practice of attending work while ill, has moved from a niche occupational health concern to a practical leadership problem. New survey evidence from Belgium shows a sharp rise in employees who work through illness as a matter of routine, U.S. federal data released in September 2026 show that roughly one in five private-sector workers still lacks access to paid sick leave, and a 2026 study in Health Affairs links points-based attendance systems to substantially higher presenteeism even where paid sick leave is legally mandated. This article synthesizes research on the prevalence, drivers, and consequences of working while ill, drawing on peer-reviewed studies, public health investigations, and documented organizational decisions in food service, retail, freight rail, technology, chemicals, health care, and public policy. It then sets out five evidence-based responses: decoupling attendance discipline from illness, making paid sick leave usable, building coverage capacity, setting clear fitness-for-work norms through leader behavior, and supporting voluntary, adjusted work. It closes with guidance for building durable organizational capability for recovery.

Organizations routinely promote top-performing employees into management roles for visible traits like confidence and ambition, despite these attributes rarely predicting effective leadership. This systemic error, known as the promotion paradox, leads to diminished team performance, lower employee retention, and widespread workplace burnout. Research indicates that the skills required to excel in individual tasks frequently conflict with the competencies necessary for managing people successfully. Furthermore, subjective promotion criteria often introduce gender biases and protect toxic leaders in positions of authority from facing appropriate consequences. To resolve these issues, institutions must separate financial rewards from managerial tracks, implement structured evaluations, and measure leaders based on team wellbeing. Ultimately, treating management as a distinct professional craft allows organizations to build more accurate, equitable, and durable leadership selection systems.

Organizations routinely promote top-performing employees into management roles for visible traits like confidence and ambition, despite these attributes rarely predicting effective leadership. This systemic error, known as the promotion paradox, leads to diminished team performance, lower employee retention, and widespread workplace burnout. Research indicates that the skills required to excel in individual tasks frequently conflict with the competencies necessary for managing people successfully. Furthermore, subjective promotion criteria often introduce gender biases and protect toxic leaders in positions of authority from facing appropriate consequences. To resolve these issues, institutions must separate financial rewards from managerial tracks, implement structured evaluations, and measure leaders based on team wellbeing. Ultimately, treating management as a distinct professional craft allows organizations to build more accurate, equitable, and durable leadership selection systems.