The employee who seeks to benefit from being ill

The presence of physical symptoms that do not correlate with a disease process are often frustrating to healthcare professionals, are difficult to diagnose and may consume an inordinate proportion of healthcare resources. However, proper and complete physical and psychological assessment and treatment is becoming increasingly possible and essential. Physical illness may occur concomitantly and sometimes as a result of psychological distress, which has displayed itself in a diagnosed mental illness. In other cases physical symptoms may be caused by unconscious dynamics, and the process becomes the primary presenting mental concern. In other cases the physical illness is part of a conscious process and motivated by the hope of gain. Differentiation between physical symptoms of unconscious and conscious origin is important in selecting the correct response. A manager must first of all be alert for physical symptoms that appear to be consciously motivated, as in a disorder called "malingering." The essential feature of malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives such as avoiding work or obtaining financial compensation. Managers may inadvertently encourage malingering in the workplace by inappropriate responses to employees who present a physical complaint that is consciously motivated for gain. When the manager can recognize this phenomenon as malingering, appropriate managerial intervention can cause this behavior to be controlled and even eliminated and thus enhance productivity.