Job insecurity is changing how employed Americans manage their health. In a Tebra survey of 1,009 employed Americans, 33% said layoff fears had caused them to work while sick, 39% skipped preventive care to avoid using PTO, and 22% took a telehealth appointment without telling their employer. The findings suggest that for many workers, medical decisions are now being shaped by workplace visibility, PTO pressure, and fear of appearing replaceable.

Many employees no longer view taking a sick day as a simple health decision. Instead, concerns about job stability and workplace visibility are pushing workers to remain on the job, even when they are unwell.

One-third of workers (33%) said fears of layoffs had caused them to work while sick instead of taking time to recover. The pressure was highest in tech (46%) and professional and business services (44%), while healthcare (26%), manufacturing (23%), and government (23%) workers reported lower rates.

Across generations, Gen Z workers were the most likely to work while sick because of layoff concerns (38%), followed by Millennials (33%) and Gen X (33%). Work arrangement also played a role. Fully remote employees (37%) and hybrid workers (36%) were more likely than fully in-office employees (31%) to report working while sick due to concerns about job security.

Income differences revealed that lower- and middle-income workers faced greater pressure:

Workplace roles also influenced behavior. Individual contributors and managers were equally likely to work while sick because of layoff fears (34% each), while senior leaders and executives reported much lower rates (19%).

The pressure extended beyond taking sick days. More than half of workers (51%) felt they needed to stay visible and available while unwell so they would not appear replaceable. That feeling was strongest among Gen Z (57%), followed by Millennials (52%) and Gen X (46%), suggesting younger employees may feel the greatest pressure to demonstrate constant availability.

For private practices, these findings reinforce the value of offering healthcare that fits around demanding work schedules. Online scheduling, digital messaging, and telehealth appointments can help patients access care earlier, before minor illnesses become more serious.

Today's workers are making healthcare decisions based not only on their symptoms, but also on how those choices might affect their careers. As employees try to preserve PTO and avoid drawing attention at work, many are postponing preventive care or finding discreet ways to connect with providers.

More than 1 in 5 workers (22%) said they had taken a ‘stealth telehealth’ appointment to avoid revealing they were sick to an employer. Among them, 56% joined from their car, suggesting some workers are fitting medical care around workplace expectations instead of taking time away from work.

Preventive care was also taking a back seat. Nearly 2 in 5 workers (39%) skipped preventive appointments because they did not want to use PTO. At the same time, nearly one-third (31%) said they were saving PTO because they worried taking sick days could put their jobs at risk.

Healthcare employees faced some of the greatest challenges despite working within the healthcare industry. More than half (51%) skipped preventive care to protect PTO, while 49% delayed or canceled appointments. Additionally, 27% reported hiding a telehealth visit from their employer, the highest rate of any industry.

Rather than resting, many employees continued working through illnesses and symptoms, including:

These behaviors point to a practical access problem: many patients need care but are trying to avoid being visibly absent from work. Practices that offer clear scheduling options, secure patient portal communication, and virtual visits may be better positioned to reach patients before delayed care becomes more serious.

Today's employees increasingly expect healthcare to fit into their schedules instead of disrupting them. As work becomes less predictable and workers look for ways to minimize time away from the job, convenience has become an important factor when choosing a healthcare provider.

More than half of Gen Z workers (55%) said they had switched or considered switching healthcare providers to gain more convenient access to care. Millennials followed at 47%, while 36% of Gen X respondents said the same.

These findings suggest that younger generations are placing greater value on flexible healthcare experiences that work around their professional responsibilities. Features such as online appointment scheduling, telehealth, digital communication, and easier access to providers can influence where patients choose to receive care.

Healthcare that meets patients where they are

The way Americans access healthcare is changing alongside the workplace. Layoff concerns, pressure to remain visible, and limited willingness to use PTO are leading many employees to work through illness, delay preventive care, and seek more discreet ways to connect with providers. At the same time, patients are increasingly choosing practices that offer flexible access to care.

For private practices, these shifts present an opportunity to better meet patients' evolving needs. By offering online scheduling, telehealth, secure digital communication, and flexible appointment options, providers can reduce barriers to care while strengthening patient relationships. As work continues to influence healthcare decisions, practices that prioritize accessibility may become the ones patients trust most.

We surveyed 1,009 employed Americans to explore how job-security fears are reshaping the way people manage illness, medical care, and time off at work. Respondents spanned four generations: Gen Z (16%), Millennials (52%), Gen X (27%), and Baby Boomers (5%).

Respondents also represented a range of work arrangements, including fully in-office (52%), hybrid (27%), and fully remote (22%) employees. Data was collected in June 2026. Findings are based on self-reported responses. Industry, income, generation, work arrangement, and role-based findings are based on subgroup responses and should be interpreted as directional where sample sizes are smaller.

Tebra, headquartered in Southern California, empowers private healthcare practices with AI and automation to drive growth, streamline care, and boost efficiency. Our all-in-one EHR and billing platform delivers everything you need to attract and engage your patients, including online scheduling, reputation management, and digital communications.

Inspired by "vertebrae," our name embodies our mission to be the backbone of healthcare success. With over 165,000 providers and 190 million patient records, Tebra is redefining healthcare through innovation and a commitment to customer success. We're not just optimizing operations. We're ensuring private practices thrive.

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