Controlling absenteeism

May 1, 2007
Excessive absenteeism and/or tardiness can cause both emotional and financial problems for many dental offices.

by Bent Ericksen and Tim Twigg

Excessive absenteeism and/or tardiness can cause both emotional and financial problems for many dental offices. In 2005, a national survey found that the average annual cost to employers was $660 per employee. Add to that the staff stress of having to assume the absent person’s workload or arrange for a temp to fill in on a moment’s notice, and you’ll find that morale and production in the dental office are negatively affected.

Another survey designed to determine the reasons for the unscheduled absences showed that 35 percent of employees are absent for personal illness, 24 percent for family issues, 18 percent for personal reasons, 12 percent for stress, and 11 percent think they are simply entitled to the time off.

Employees were absent for reasons other than personal illness 65 percent of the time. In a survey conducted by Career Builder, results showed that 62 percent of managers did not believe many sick day alibis. Believe it or not, some excuses employees offered for not coming to work were: “I was poisoned by my mother-in-law,” “I broke my leg snowboarding off my roof while drunk,” and “A skunk got into my house and sprayed all my uniforms and the smell got me sick.”

Many employers find that “presenteeism” is also a concern. Presenteeism happens when sick people show up for work. They are less productive, and they pass along contagious illnesses to co-workers and patients, which also negatively affects morale and production.

There are many reasons employees come to work when they really should stay home to recuperate. They feel loyal and devoted to the practice; they are afraid of falling behind in their work or that other employees will not do it well enough; or the financial impact of reduced pay is heavy. Other reasons may be that they have used all their paid sick time and do not want to use their vacation time (if any is left), or they are afraid of disciplinary action. (A 2006 CCH survey found that disciplinary action is still the number one program to help control high rates of absences.)

A recent study, “Fatigue in the U.S. Workforce: Prevalence and Implications for Lost Productive Work Time,” reported in the Journal of Occupational and Environmental Medicine, indicated that health-related, reduced-work performance - also known as presenteeism - caused a loss of concentration, repeating (or rechecking) a job, working slower than usual, feeling fatigued or not working, and increasing the time it takes between arriving at work and starting to work.

To that add being late for work, making technical and financial mistakes, and infecting other employees - and the cycle repeats itself. Take into consideration that as other employees become ill, they may have to use paid sick leave or vacation time or take unpaid time off.

A solution

How do you effectively manage and instill the respect and work ethic that motivates employees to report to work when they are not ill and encourages them to stay home when they are ill?

Have a written sick leave policy that communicates the attendance goals of the practice. The policy should include:

  • What constitutes an unacceptable attendance record. That would include time off for illness as well as personal time off for reasons other than illness. Your paid sick leave benefit should provide a certain number of days off when ill, usually six to seven days a year for full-time employees. Any time over that could be considered excessive. Government mandated time off, such as the Family and Medical Leave Act (FMLA), cannot be classified as “unacceptable” and should not be regarded as such.
  • How to report an absence. This would include the name and number of the person to call. Employees are to contact that person as soon as they become aware that they cannot report to work so as to decrease the adverse impact on the practice.
  • At what point does the sick time become a medical leave of absence? This usually happens after four to five days of absence. Some leaves are legally mandated and some are not. For example, if the employer has 50 or more employees, and therefore must adhere to the requirements of the FMLA, a leave must usually be granted. However, if an employee requests a Personal Leave of Absence due to illness, such a leave is often discretionary.
  • Under what circumstances must a health-care provider’s note with permission to return to work be given to the employer? This should be established in your policy and applied consistently.
  • In lieu of traditional time-off policies, consider using “paid time off” where those various leaves are combined into a single leave bank.

Consequences, problem prevention

Deal with excessive absenteeism properly and effectively. You can discipline an employee who does not meet legitimate attendance requirements - up to and including discharge. Follow through with appropriate action in each case so that no one can claim that he or she is being treated unequally. This will help to prevent charges of discrimination.

To prevent problems with the Americans With Disabilities Act (ADA) or similar state laws as they relate to attendance, identify the job functions that are “essential” for the position and list them as such in the written job description. The essential functions of a job are the fundamental duties of the position. Some of the factors are whether the function is listed in the written job description, the amount of time that is spent in performing this function, the level of expertise or skill required, the consequences if the function is not done, and whether other employees can do the job without creating “undue hardship” for the employer.

Contact our office for information on purchasing specific ADA-compliant job descriptions for each position in the dental office.

Absenteeism and presenteeism are two significant challenges every employer must address. Through a better understanding of what motivates employees in these areas as well as the alternatives that are available, employers will be able to address such matters effectively and help increase the efficiency of their practices.

Bent Ericksen is the founder and Tim Twigg is the president of Bent Ericksen and Associates. For more than 25 years, the company has been a leading authority in human resources and personnel issues, helping dentists successfully deal with the ever-changing and complex labor laws. Both authors are members of the Academy of Dental Management Consultants. To receive a complimentary copy of the company’s quarterly newsletter or to learn more about their services, contact them at (800) 679-2760 or at

Ways to create a work environment that helps improve attendance

Create a work environment that inspires employees to come to work. Employees are motivated and perform at their very best when they feel they are receiving respect, recognition, fair compensation, and adequate benefits. The benefit that employees consider most valuable is medical insurance.

Help employees fully understand and commit to the goals of the practice.

Have a written job description for each position so there are no misunderstandings as to what the job entails.

Have a meeting with each employee to discuss the details of the job. Discuss strengths and limitations, the steps he or she can personally take to improve his or her skills, and what the employer will do to assist in that goal. That could mean getting trained by a co-worker, a practice-management consultant, or through continuing-education sessions and seminars.

Let employees know how you rate their performance. Conduct a performance review at least once a year where specific job functions are openly and frankly documented and discussed. Review the employee’s performance on such topics as quality and quantity of work, job knowledge, and staff and patient relations. Also, list items that the employee is doing well and items in need of improvement. Include an action plan for improvement where needed. Let your employees know that you are committed to help them improve and that you must also have a similar commitment from them.

Praise employees when it is earned. It is easier to compliment above-average work performance than it is to criticize substandard performance. Be specific in your praise. Relate it to a particular task or situation that was done exceptionally well. Then place a note in the employee’s file and use these otherwise-forgotten incidents to assist you in preparing a comprehensive and fair performance review. There will be times when someone is doing work that is less than acceptable, and that type of documentation should also go into the file to assist at review time. The evaluation should contain no surprises for the employee.

Sponsored Recommendations

Clinical Study: OraCare Reduced Probing Depths 4450% Better than Brushing Alone

Good oral hygiene is essential to preserving gum health. In this study the improvements seen were statistically superior at reducing pocket depth than brushing alone (control ...

Clincial Study: OraCare Proven to Improve Gingival Health by 604% in just a 6 Week Period

A new clinical study reveals how OraCare showed improvement in the whole mouth as bleeding, plaque reduction, interproximal sites, and probing depths were all evaluated. All areas...

Chlorine Dioxide Efficacy Against Pathogens and How it Compares to Chlorhexidine

Explore our library of studies to learn about the historical application of chlorine dioxide, efficacy against pathogens, how it compares to chlorhexidine and more.

Enhancing Your Practice Growth with Chairside Milling

When practice growth and predictability matter...Get more output with less input discover chairside milling.