December 17, 2004, should have been a day of celebration.

Nellie Jo and I had been married 27 years on that date. We were in Naples, Florida, enjoying the sunshine and each other. 

Then the phone call came.

We had been given a great deal of confidence that the biopsy would likely prove negative. Proceed with our anniversary celebration, we were told. In the unlikely event that the report was not good, they would let us know.

The report was not good. Nellie Jo had cancer. The next two years would prove to be some of the most challenging years of our lives and marriage.

Looking back, it is amazing to recall how healthy Nellie Jo looked. She showed no signs of fatigue or sickness. Had she not seen a couple of warning signs, she might have found out too late about her cancer. She might not be alive today. 

I’ve seen it countless times. My team would go into a church for a consultation, and we would begin interviewing church members. We would hear from many of the congregants that their church was healthy and thriving. Then we would see the warning signs. And we would begin to fear that the apparently healthy body was not really healthy at all.

The church was sick. Some of the churches were really sick. 

What were some of the warning signs my team saw? Though the list is not exhaustive, these five issues were common. Some of the churches had a one or two on the list; some had all five. 

1. The church has few outwardly focused ministries. Most of the budget dollars in the church are spent on the desires and comforts of church members. The ministry staff spends most of its time taking care of members, with little time to reach out and minister to the community the church is supposed to serve. 

2. The dropout rate is increasing. Members are leaving for other churches in the community, or they are leaving the local church completely. A common exit interview theme we heard was a lack of deep biblical teaching and preaching in the church. 

3. The church is experiencing conflict over issues of budgets and building. When the focus of church members becomes how the facilities and money can meet their preferences, church health is clearly on the wane. 

4. Corporate prayer is minimized. If the church makes prayer a low priority, it makes God a low priority. 

5. The pastor has become a chaplain. The church members view the pastor as their personal chaplain, expecting him to be on call for their needs and preferences. When he doesn’t make a visit at the expected time, or when he doesn’t show up for the Bible class fellowship, he receives criticism. In not a few cases, the pastor has lost his job at that church because he was not omnipresent for the church members. 

The bad news is that few churches recover if the patterns above become normative. The church is a church in name only. It is self-gratifying rather than missional. It is more concerned about great comfort than the Great Commission and the Great Commandment. 

The good news is that a few churches have moved from sickness to health. The path was not easy. It first required that the congregants be brutally honest with themselves and God. It does no good to speak glowingly of a church that is unhealthy and getting worse. 

Many of the turnaround churches we consulted then moved to a time of corporate confession and repentance. They confessed to God their lack of obedience and their selfish desire for their own comfort.

And still other churches made an intentional effort to shift the ministries and the money of the church to a greater outward focus. This step can be particularly painful since a number of church members often protest with vigor that their needs are no longer being met. 

Indeed we could focus on the reality that the great majority of sick churches do not recover. But that focus provides little value.

We should look at the admittedly few churches that have moved from sickness to health. We should learn how they turned from an inward focus to an outward focus. We should follow their examples of moving from selfish desires to radical obedience to God. 

In His power the unhealthy church can become healthy.

Heed the warning signs.

It could be the difference between life and death. 

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Thom Rainer is the president and CEO of LifeWay Christian Resources, and for 15 years prior to that led a church and denominational consulting firm. He is the author of 21 books, including his latest, "Simple Life."