Commentary: ‘Excessive’ MCs – the real question is why absenteeism is still seen as worse than presenteeism

SINGAPORE: You’ve woken up under the weather – fatigue, aches, a nagging cough – and dragging yourself to the office sounds like a bad idea for everyone. You opt to see a doctor via video consultation instead and minutes later, a medical certificate (MC) for two days of sick leave lands in your inbox.
Convenient? Absolutely. However, the ease of obtaining online MCs has sparked concerns over potential misuse and absenteeism. And perhaps when major sporting events take place in a different time zone, like the World Cup or the Olympic Games, some employers may view MCs with more scepticism.
In April, the Ministry of Health (MOH) said it was looking to address the “excessive issuance” of MCs, particularly after teleconsultations. In a circular to doctors, MOH highlighted allegations that MCs were given without proper clinical assessment or to those who said they just wanted certification to skip work or school, calling it “malingering and abusing medical leave privileges”. 
CNA had reported easily getting MCs via three telemedicine apps in July 2023, with one consultation lasting only 43 seconds.
Singapore’s telemedicine boom has been a game-changer. More people can get the care they need despite juggling hectic schedules or facing mobility issues, with a few taps.
However, such convenience can be a double-edged sword. Critics argue this erodes workplace accountability and enables a lax work ethic. But are the doctors really to blame for giving the patients the benefit of the doubt? 
The root cause is more likely a deep-seated trust deficit between employers and employees.
The more employers question employees’ integrity, the more likely those employees are to reinforce that perceived lack of trust.
Trust has been put to the test since COVID-19 forced employers to send employees home then accede to some hybrid arrangements post-pandemic. But out of fear remote employees might not be working, some employers resorted to surveillance, such as tracking their mouse activity. 
Employees responded by buying mouse jigglers, a USB device which simulates mouse cursor movements every few minutes so they appeared online on email or messaging apps.
Mistrust breeds more mistrust. Workers who feel micromanaged, undervalued or disrespected are more prone to “playing the system”.
And another way to do that is by taking MCs when they aren’t sick. Many organisational psychology research studies point to a link between engagement and absenteeism, with less engaged employees more likely to call in sick more frequently.
It seems strange that employees are not trusted to use sick leave judiciously when they are often entrusted with greater responsibilities, like large projects, budgets or other assets.
Instead of scrutinising MCs and counting sick days, employers should operate with the understanding that work will get done as long as employees feel genuinely supported and valued. 
When people don’t feel the need to lie about being ill, they can simply prioritise their physical and mental health, preventing more serious issues down the line.  
Why not treat employees like adults capable of responsibly managing their time and health? And why is absenteeism still seen more negatively than presenteeism?
Presenteeism is costly for employers. During occasional COVID-19 waves or the flu season, employees who turn up in the office unwell run the risk of infecting colleagues, leading to greater absenteeism. Those who feel expected to “power through” physical or mental health symptoms to continue working have lower productivity and engagement. 
A 2022 local study found that absent employees missed 17.7 days on average per year due to depression and anxiety symptoms, but that lower productivity while present meant they ended up missing an equivalent of 104 days on average per year. 
Trust goes both ways, and 79 per cent of employees who trust their employers said they were more motivated to work and less likely to leave, according to a 2023 Visier survey of US employees. 
Even after scandals or controversies, 42 per cent of employees said how their company reacted improved their trust levels. So, building and maintaining trust is an ongoing process that impacts employee engagement, retention and the company’s reputation.
Gaining that trust comes from hygiene factors such as relationships, working environment and of course, a fair salary. Fostering such a culture requires strong leadership. 
Leaders must implement transparent policies and walk the talk. They set the tone for workplace culture by not tolerating toxic behaviour, respecting work-life boundaries and providing the psychological safety for employees to speak up about concerns and ideas. Anonymous feedback channels, frequent check-ins and a willingness to truly listen can help break down the barriers that allow mistrust to fester.
Leaders must also work on motivators like signalling that employees’ efforts are valued though consistent recognition and rewards, such as bonuses and growth opportunities.
When companies actively invest in their employees’ well-being, those employees are far more likely to be motivated and loyal – going the extra mile without thinking of taking advantage of that trust. 
Most leaders know all this in theory, putting it into practice is always more challenging. When employees feel genuinely cared for and supported, there’s far less need to take advantage of or obtain that MC under questionable circumstances.
Employers should not come to the conclusion that they should operate on blind faith – employees must still get the work done. But it’s time to move beyond rigid attendance policies and sick day restrictions.
That would be real progress. 
Lee Boon Huat is Senior Vice President of Growth & Strategy, APAC in people analytics company Visier.