Sixty percent of workers Gympass surveyed said they’re overall doing well—or even thriving. But the report finds that many workers still struggle with a “wellness deficit,” characterized by a drop in mental or physical health. When either of these suffers, bosses need to worry about absenteeism and presenteeism, in which workers are checked out.

“When your team is healthy and happy, they’re also more productive, present, and engaged,” Cesar Carvalho, Gympass’s CEO and cofounder, tells Fortune. “Business and HR leaders are focused on absenteeism but also need to be focused on presenteeism, which is even more widespread.”

Since the pandemic, more employees have been physically at work but actually unproductive due to distractions like illness, anxiety, or other preoccupations, he added. “More than 60% of employees are detached, and employee stress is at an all-time high.” 

Workers who aren’t present at work are, naturally, a huge drag on productivity. But there’s a gulf of difference between physically absent workers (absenteeism) and mentally checked-out workers (presenteeism). Presenteeism, unlike absenteeism, can fly under the radar until it’s too late—especially if bosses fall victim to proximity bias and use physical presence as the main indicator of performance. Forces like burnout, harassment, mental illness, demotivation, lack of team chemistry, conflicts, time management, and stress are all main culprits, as are personal or health issues.

Presenteeism is also much more costly for businesses, Gympass points out—10 times as much as absenteeism. While absent workers in the U.S. cost their companies around $150 billion each year, those who came to work but weren’t fully there cost $1.5 trillion per year in lost productivity.

But it doesn’t have to be so complicated. Gympass’s report offers a straightforward solution: prioritizing wellness in all areas—emotional, physical, intellectual, social, financial, and so on—and not letting workers forget it. Of course, Gympass has some skin in the game considering it offers an all-in-one wellness benefit to employees. But research shows that that effort isn’t wasted; workers genuinely perform better when their non-work needs (physical, emotional, and social) are met.

Greater flexibility can stop workers from phoning it in

Companies’ lack of attention to wellness, and the ensuing problem of presenteeism, has been causing issues for decades. A 2004 Harvard Business Review article posited that presenteeism can knock down productivity by a third—or more—and is much worse than absenteeism. “You know when someone doesn’t show up for work, but you often can’t tell when—or how much—illness or a medical condition is hindering someone’s performance,” editor Paul Hemp wrote.

And, since it’s 2023, the problem no longer requires in-office participation to permeate a workplace.

A 2022 report from Qatalog and GitLab found that the average knowledge worker, when remote, wastes 67 minutes online each day doing menial tasks—jiggling their mouse, opening and closing tabs—just to keep their status as active so their bosses think they’re available and working. They dub the trend “digital presenteeism,” because it relies on the same basic formula as real-life presenteeism, where a worker twiddles their thumbs at their cubicle until the clock strikes five. 

Whether you’re “responding to notifications, or sitting in Zoom meetings you don’t need to attend,” that report wrote—you’re really just wasting time, and it (predictably) doesn’t even correlate to any better work output. 

Indeed, those extra 67 minutes would be better spent on pretty much anything else—even non-work activities, which would create a buffer and stave off burnout. The real fix to presenteeism, the Qatalog/GitLab report found, is offering actual flexibility, which would dissuade workers from feeling an ambient pressure to put in hollow time. 

Eighty-one percent of respondents to that report said they’re more productive and turn in higher-quality work when they’re given flexible hours, and that the pressure to be online just for the sake of being online is totally counterproductive. 

The Gympass report advises bosses to ignore the hollow indicators of performance—like whether people are in the office—and focus on output. And the time-tested method to encourage strong performance is always to prioritize flexibility and ensure that workers feel genuinely looked after and valued.

As they wrote in their conclusion, there is no productivity without well-being. “Sick people cannot bring their A game, stressed people are distracted, and exhausted people cannot focus,” they said. “Being well is the foundation of working well.”