Labor Shortages and Health: What Small and Medium-Sized Businesses Can Do

Visit labor shortage has a particularly severe impact on Quebec SMEs. Hiring is expensive, and every departure takes a toll on the remaining team, increasing the risk of burnout and further departures. Investing in the Workplace Health in Small and Medium-Sized Enterprises becomes a practical retention tool—often less expensive than hiring a new employee. According to the Quebec Employers’ Council, the cost of an employee leaving ranges from 30 % and 100 % of the annual salary for the position to be filled [1]. This article suggests five practical strategies—applicable even in organizations with 10 to 100 employees—and provides an overview of the assistance available in Quebec.

On this page

• The Hidden Cost of Neglected Health
• 5 Health Initiatives Available to Small and Medium-Sized Businesses
• Building a Culture of Sustainable Prevention
• Quebec Subsidies and Incentives
• Evaluating Return on Investment
• Where should you start in a small business?
• Myths and Misconceptions
• Frequently asked questions
• Sources

The Hidden Cost of Neglected Health

The direct cost of health care is just the tip of the iceberg. The indirect costs The costs of neglected workplace health issues are often far greater than the investments required to prevent them.

The Four Hidden Costs You Need to Know About

• Absenteeism — sick days reported, tracked, and visible in payroll
• Presenteeism — an employee who is present but not very productive (due to fatigue, chronic pain, or anxiety). Often more costly than absenteeism according to several Canadian studies [2]
• Staff Turnover — estimated replacement cost between 30 % and 100 % of the annual salary depending on the complexity of the position [1]
• Errors and Accidents related to fatigue, stress, or cognitive overload

Some Key Figures to Keep in Mind

• The annual cost of mental health issues at work is estimated to be more than 50 billion dollars in Canada [3]
• Nearly 1 in 4 workers is associated with high levels of stress at work [4]
• Disorders musculoskeletal are the leading cause of short- and medium-term disability
• Quebec SMEs lose, on average, 8 to 12 days per employee per year absences from all causes combined
• A mental health worker is up to three times more engaged than an employee who is struggling

5 Health Initiatives Available to Small and Medium-Sized Businesses

You don't need a big-company budget to make a difference. Here's five concrete actions, to be implemented gradually, offering an excellent cost-benefit ratio for most small and medium-sized enterprises.

1. Quick access to a doctor

Access to a teleconsultation service or a partnership with a clinic significantly reduces time spent in the waiting room and speeds up a return to work. It is often the most cost-effective investment, at a modest cost per employee per month.

• Teleconsultation upon request, ideally bilingual
• Community-Based Clinical Follow-Up for checkups, vaccinations, and routine care
• Option to medical bills quick and common prescriptions
• Access is also available to spouses and children based on agreements — a factor in customer loyalty

2. Employee Assistance Program (EAP)

Visit PAE provides confidential psychological, legal, and financial support to employees. Particularly cost-effective in environments with high cognitive load, where stress and burnout take a heavy toll.

• Complete confidentiality — The employer has no access to individual records
• A few sessions covered per year per employee
• Extensive support often to the spouse and children
• Monthly cost per employee usually between 5 $ and 15 $, depending on the size and supplier
• Return on Investment Studies showing a return of 3 to 8 $ per dollar invested [5]

3. Seasonal Vaccination in the Workplace

A on-site vaccination clinic Two to three hours is usually enough to vaccinate an entire team against seasonal flu, with a net gain in terms of’winter absenteeism and productivity from January through March.

• Flu vaccination in a mobile clinic at the workplace
• Update traveler vaccinations, pertussis, and COVID-19, in accordance with the recommendations
• Employee Coverage in sectors that provide direct services to the public (health care, education, food service) and are particularly profitable
• Possible combination with a quick health checkup on site

4. Periodic Health Checkup

A a health checkup every 2 to 3 years, ideally combined with targeted prevention, makes it possible to detect modifiable risk factors early and refer employees to the appropriate resources.

• Questionnaire Health and Lifestyle Habits
• Clinical examination and measurements (blood pressure, BMI, waist circumference)
• Blood tests basic tests (blood glucose, lipids) based on age and risk factors
• Targeted Prevention : smoking, a sedentary lifestyle, sleep, stress
• Reference to a family doctor or a specialist, if necessary

5. Culture of Prevention

No external service can replace a internal culture that takes health seriously. This approach is inexpensive but requires consistency over time.

• Active Breaks encouraged (stretching, walking, short breaks)
• Ergonomics reviewed regularly (workstations, monitors, chairs)
• Realistic workloads and prompt reassignment in the event of an absence
• Reasonable flexibility work schedules (partial remote work, flexible hours)
• Regular Recognition for the work accomplished
• Clear Policy against harassment, incivility, and chronic overload

Key Takeaways

• Visit presenteeism often costs more than absenteeism and remains largely unseen
• Visit cost of a trip ranges from 30 to 100 % of the position's annual salary
• Five levers accessible to small and medium-sized businesses provide quick results: medical care, employee assistance programs, vaccinations, checkups, and cultures
• Visit Quebec government grants (CNESST, BNQ 9700-800, tax credits) can significantly reduce the bill
• A investment in organizational health often yields 3 to 5 times the initial investment over a few years
• Visit internal culture is the most predictive factor for long-term retention

Building a Culture of Sustainable Prevention

Medical services and formal programs are only fully effective in a a work environment that takes health seriously every day. Here are the ingredients for a strong culture of prevention.

The Pillars of a Culture of Health

• Visible Commitment from management—not just posters, but concrete decisions
• Clear Communication on available resources (Employee Assistance Program, telemedicine, vaccination)
• Management Training to recognize the signs of burnout and have difficult conversations
• Regular measurement workplace climate (short, anonymous surveys followed by action plans)
• Consistency between rhetoric and practice (workload, schedules, time off)
• Employee Participation in the design of health initiatives

Common Pitfalls

• «Cosmetic» programs» without any real commitment from management
• One-time initiatives not incorporated into daily life (a one-time "wellness week")
• Workloads that contradict the prevention message
• Lack of confidentiality perceived or actual
• Lack of action results over a 2- to 3-year period

Quebec Subsidies and Incentives

Several Quebec programs can provide financial or technical support to small and medium-sized businesses that invest in workplace health. Here are the main ones you should know about.

Key Programs and Support Services

Program	Target	Type of Support
CNESST Prevention Mutuals	All SMEs that pay contributions	Reduction in the CNESST premium in exchange for prevention efforts
BNQ Standard 9700-800 — Healthy Workplace	Companies of all sizes	Certification Framework, Support, Recognition
Training Tax Credits (Investissement Québec)	Growing Small and Medium-Sized Enterprises	Tax Credit for Employee Training, Including Occupational Health
Ergonomic Grants sector-specific	Manufacturing, Transportation, Services	Assistance with workplace design and preventive equipment
INSPQ Programs	All organizations	Free tools, guides, and training on organizational health
Emploi-Québec Credits	SMEs with training needs	Partial Funding for Training and Integration

A discussion with an organizational health consultant or through a workplace health and safety program helps identify the most relevant programs based on the industry and the size of the company.

Evaluating Return on Investment

Workplace wellness programs are measurable. Several metrics can be used to objectively quantify the benefits and convince management to continue investing in them.

Key Metrics to Monitor

• Absenteeism Rate (days lost per employee per year)
• Turnover Rate annual (voluntary and involuntary departures)
• Average Replacement Cost related to an employee (hiring, training, loss of productivity)
• Engagement Score through an internal survey
• Use of Services (PAE, teleconsultation) — a rate that is too low may indicate a communication or trust issue
• Retention Rate at 1 year, 2 years, 5 years
• Incidents and Injuries reported to the CNESST

A Measurable Return

Several Canadian and Quebec studies report a return on investment located between 3 and 5 $ per dollar invested in organizational health over a 3- to 5-year period [5]. The most rapid improvements are seen in absenteeism, presenteeism, and retention, particularly in settings with high mental workload.

Do you run a small or medium-sized business and want to take concrete action? Omicron Clinic offers medical services for businesses at our locations in Quebec: telemedicine consultations for employees, on-site vaccinations, health screenings, medical consultation, and support for updating health programs. View the B2B offering or set up a meeting to discuss your situation.

Where should you start in a small business?

You don't have to roll everything out at once. Here's a realistic scene over 12 months, applicable to an SME with 20 to 100 employees.

12-Month Action Plan

1. Months 1–2 — Assessment: absenteeism rate, turnover rate, short internal survey, identification of key sources of frustration
2. Months 2–3 — Internal communication: raising awareness, highlighting existing resources (Employee Assistance Program, RAMQ, family doctor)
3. Months 3–5 — Establishment of a teleconsultation service and/or an Employee Assistance Program (EAP) if one does not already exist
4. Months 5–7 — First on-site vaccination clinic (ideally in October–November)
5. Months 7–10 — Ergonomic review of priority workstations
6. Months 10–12 — Annual Review: Metrics, Satisfaction, Plan Adjustments

Pitfalls to Avoid When Starting Out

• Launch a program Without measuring the starting point—it’s impossible to assess the gains afterward
• Do not involve employees in the design of initiatives
• Expand the number of initiatives inconsistent (more isn't necessarily better)
• Confusing Health and Well-Being — A basket of fruit is no substitute for access to a doctor
• Forget About Managers — Their training is a key lever

Myths and Misconceptions

«Occupational health is only for large companies»

False. SMEs have access to the same tools as large organizations, often at a lower cost per employee. Moreover, the close-knit nature of a 20-person team allows for a measurable impact more quickly than in a large company.

«If we offer an employee assistance program, no one will use it.»

Mostly fake. EAP utilization rates often reach 8 to 15 % per year in settings that actively communicate their availability. Low utilization is more often due to a lack of visibility than to a lack of need.

«Teleconsultation isn't really medicine»

False. Teleconsultations are regulated by the Collège des médecins du Québec and can address most common health issues: respiratory infections, general dermatology, blood pressure monitoring, mental health, and prescription renewals. Cases requiring a physical examination are referred to another provider.

«Presenteeism can't be measured»

False. Validated questionnaires (WHO-HPQ, Stanford Presenteeism Scale) are used to estimate presenteeism. Beyond formal measurements, indirect indicators (errors, quality, delays, customer satisfaction) often reflect the losses associated with presenteeism.

«Investing in healthcare won't make a difference in retention.»

False. Retention surveys consistently show that mental health, work-life balance, and the feeling of being valued are among the top five reasons for staying (or leaving) an organization, particularly among workers under the age of 40.

Frequently asked questions

How many employees does a company need to have before it’s worth offering an EAP?

Several providers offer EAPs for companies with as few as 10 employees—and sometimes even fewer—through group plans or group insurance. The monthly cost per employee is usually modest, and the break-even point is often reached as soon as a single consultation helps prevent a prolonged absence or an employee leaving the company.

Does the RAMQ cover teleconsultations for employees?

Some telemedicine consultations are covered by the RAMQ when provided by certain participating physicians. Several private or employer-sponsored services supplement this coverage to provide faster access. Talking with your provider can help clarify what is covered and what is supplemental.

What are the obligations of a Quebec employer regarding occupational health?

The main obligations are set forth in the Occupational Health and Safety Act (LSST) and the Act to Modernize the Occupational Health and Safety System. These include risk assessment, implementing a prevention program, training employees, and participating in a mutual aid group or committee, depending on the size of the organization. Organizational health programs go beyond these obligations and are a voluntary initiative.

How much does an on-site vaccination clinic cost?

The cost depends on the number of employees, the type of vaccines offered, and the provider. Seasonal flu vaccination in the workplace is often one of the most cost-effective investments in corporate health, particularly for teams who interact with the public or the elderly. You can get a customized quote by speaking with your provider.

Do workplace health screenings replace the family doctor?

No. These screenings are a supplementary tool that helps detect risk factors early and refer employees to the appropriate resources, such as their family doctor or a follow-up clinic. They do not replace ongoing medical care, particularly for chronic conditions.

How long does it take to see results in terms of retention?

The first improvements in absenteeism and presenteeism are often visible within the first 6 to 12 months. The effects on employee retention are typically measured over 18 to 36 months, as the internal culture evolves and employee cohorts stabilize. Rigorous monitoring of key performance indicators allows for an objective assessment of progress.

Sources

1. Quebec Employers' Council. Labor Market Conditions and Turnover Costs.
2. INSPQ — Quebec National Institute of Public Health. Workplace Health — Guides and Data.
3. Mental Health Commission of Canada. The Economic Cost of Mental Health in the Workplace.
4. Statistics Canada. Work-Related Stress in Canada.
5. Quebec Standards Bureau (BNQ). BNQ Standard 9700-800 — Healthy Workplace.
6. CNESST. Prevention Associations and Prevention Programs.
7. Investissement Québec. Training Tax Credits.
8. Quebec Ministry of Labor. Health and safety at work.

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