If employees are working while sick, your policies aren’t the problem—your structure is. To tackle presenteeism, start by addressing the root causes: job design, cultural expectations, and the imbalance between demands and support. Use this three-part framework to guide change.

Map demands and resources across roles. Identify where job demands—like workload, schedule rigidity, or constant availability—outpace support resources such as flexibility, autonomy, and managerial backup. Run confidential surveys and focus groups to pinpoint risk. Use these insights to rebalance work.

Train managers to spot and respond to early stress signals.Managers are the front line. Teach them to recognize presenteeism cues—late-night emails, unwell employees showing up, skipped sick days. Equip them with tools to intervene early, such as redistributing work or offering temporary schedule changes to ease burdens before burnout takes hold.

Create a feedback loop—and act on it. Structural change isn’t one-and-done. Use recurring surveys to monitor shifting demands and respond visibly. Adjust workloads, move deadlines, or reassign projects when pressure spikes. Demonstrating timely follow-through builds trust and keeps presenteeism from becoming a part of your organization’s culture.

Adapted from Research: Why Employees Work While Sick—and How Leaders Can Stop It by Monica L. Wang
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