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Recently, a department manager raised a question concerning an issue that frequently surfaces with managers who must regularly address employee absenteeism:


What can I do with an employee who is a good worker but who also generates a great deal of absenteeism because of legitimate illness? We have sent this person to our employee health physician who concluded that this individual's condition is chronic. We should expect, we are told, for this employee to be periodically absent for lengthy periods and that there's nothing that can be done to change this.


This is one of those issues that most persons involved in day-to-day management would like to avoid altogether. What makes this a difficult situation, of course, is found in the few words: "Who is a good worker."


First-line managers and even some middle managers take a variety of approaches to absenteeism. Some simply ignore it, looking the other way, perhaps unconsciously hoping that it never gets too far out of hand. Some others involved in direct supervision take absenteeism seriously and attempt to deal with it. These latter managers know that their visible attention to absenteeism alone is often enough of a force to help keep a lid on excessive absenteeism. But it is also these latter managers who count among their numbers the managers who, although conscientiously attempting to address absenteeism, become distressed when the situation described in the question hits their departments.


Most managers who deal regularly with absenteeism do not have a great deal of difficulty addressing the kinds of absenteeism resulting from the apparent abuse of work rules and policies. Although the manager needs to accept at face value the supposed "illness" of someone who calls in according to policy, common sense and policy allow the manager to address certain attendance problems as they arise. Common sense usually suggests that someone who is regularly "sick" on Friday or Monday, thus stretching a weekend, or who calls in when scheduled to work an undesirable shift (weekend, holiday, etc) is highly likely to be abusing sick time.


Managers can ordinarily deal with the apparent abusers without too much difficulty, but addressing the absenteeism of someone who is liked and who is also known to have a chronic health problem can be distressing to the manager. This can be especially so for managers who are keenly aware that personnel policies must be applied uniformly to all employees; there can be no differential treatment of employees based on what the manager believes or knows about an employee's reasons for being absent.


To the manager asking the question, we can only offer the reminder that absenteeism must be addressed consistently according to policy regardless of individual circumstances. In the instance of the "good worker," however, the department manager might consider the following:


* Ask the employee to accept part-time status, providing this is consistent with departmental needs.


* Suggest per-diem status under which this employee could be utilized when available.


* Recommend that the employee apply for short-term disability if any absence is such that the initial qualifying period is satisfied (usually 1 workweek or 7 calendar days), thus protecting the person's employment for an extended period as long as a physician has declared the individual unable to work.


* Suggest a leave of absence under either the organization's policies or the Family and Medical Leave Act so the individual's employment can be protected for a longer period.



Although all employees must indeed be treated equally under policy, the system abusers, those who consume their sick time as quickly as it is earned, will not qualify for the extended protections available to the employee who is medically deemed to be chronically ill.


This issue of The Health Care Manager (issue 37:2, April-June 2018) includes the following articles for the reader's consideration:


* "Using Technology to Improve Access to Mental Health Services" addresses the ways in which technological advances have shown the potential to increase access to mental health services for many patients, dealing with issues such as access to care and the societal stigma related to mental health issues.


* "Theory X/Y in the Health Care Setting: Employee Perceptions, Attitudes, and Behaviors" reports on an empirical study undertaken to examine the relationships between health care employees' perceptions of (1) manager theory Y and theory X orientations; (2) work unit psychological safety, organizational citizenship behavior, and service quality; and (3) the employing entity.


* "Contributors to Operating Room Underutilization and Implications for Hospital Administrators" reports on an investigation covering a 12-month period at an academic medical center undertaken to identify practices and conditions contributing to and identifying OR underutilization.


* "Provider Reimbursement Following the Affordable Care Act" reports on research undertaken to study the effects of the Affordable Care Act on physician reimbursement rates from the Centers for Medicare & Medicaid Services to determine the most cost effective method of delivering health care services.


* "PCMH Undergraduate Internship, Benefits to a Practice Manager: Case Study" presents the process undertaken and the benefits, challenges, lessons learned, and recommendations for interns, practice mangers, and educators as interns become PCMH facilitators.


* "Challenges of Vaccinations in the Era of New Media Communication" reports on a study undertaken to examine the strategies and tasks of health communication in relation to vaccinations.


* "Strategies Used for Fighting Medicare Fraud" reports on an investigation undertaken to identify methods of Medicare fraud, examine the various programs implemented by the US government to combat fraud and abuse, and assess the effectiveness of these programs.


* The "Case in Health Care Management" asks the reader to consider how a department manager should react to or deal with unsolicited information brought forward by a tale-telling individual claiming various forms of misconduct by fellow employees while asking to remain completely anonymous.


* "The Challenges of Leadership" enumerates 5 essential leadership challenges and suggests how one can take on these challenges to become a more effective and respected leader.


* "The Factors Affecting Teaching and Learning Professionalism Among Medical Teachers" reports on a study undertaken to identify themes that can explain effective factors in teaching and learning professionalism among medical teachers.


* "Interpersonal Conflict and Organizational Commitment Among Licensed Practical Nurses" deals with a study undertaken to examine whether perceived interpersonal conflict influences organizational commitment among licensed practical nurses.


* "Use of Motivational Interviewing by Nurse Leaders: Coaching for Performance, Professional Development, and Career Goal Setting" describes a project intended to identify evidence supporting the application of motivational interviewing strategies and principles by nurse leaders and to report outcomes of an educational pilot project regarding motivational interviewing use for new nurse leaders.