It wasn't the surgery that killed him.
The boy died because hospital residents and nurses overlooked signs that the postoperative pain control regimen had gone awry.
Autopsy revealed the error. He bled to death internally via a perforated ulcer brought on by pain meds he had been given as part of his treatment.
It was a tragic case of professional attitudes and diagnostic preconceptions led to catastrophic failure—the death of an otherwise healthy fifteen-year-old boy.
The same problem—preconceptions and attitudes that obscure otherwise evident problems—may lie at the heart of many a church's failure to recognize serious trouble. In our ministry we have found that pastors, church leaders, and congregants overlook the obvious signs, focusing on those few data points that allow them to feel comfortable in their plight.
The following list is far from complete. My objective isn't to produce the definitive list; it is to motivate pastors, church leaders, and congregants to set aside their preconceptions, approach the condition of their churches with open minds, and then listen closely to what the patient is telling them. They will recognize whether the church is in need of change lest it die.
1. The church isn't praying for laborers, open doors, and for evangelistic success.
On numerous occasions (e.g., Matthew 9:35-38; Luke 10) Jesus instructed us to always be prayerful for the gospel's effectiveness. Paul prayed diligently for opportunity, for the right words to say, and for successful evangelistic endeavors (e.g. Colossians 4:2-4). He often recruited the churches to join him in these prayers.
What signs reveal that your church prays regularly and fervently to the Lord of the harvest? The people in the church should be praying for laborers to enter the field, for boldness to speak clearly and persuasively in the face of hostility, and for open doors to the people in their social circles and to the people in the community.
2. Lagging indicators reveal unproductive processes.
Churches and pastors tend to pay attention to lagging indicators- things like attendance, income, baptisms, membership. Metrics of this type are the results of the systems and procedures already at work in your church.
By looking more closely at these lagging indicators, and analyzing what they mean, you will discover where change needs to occur. For example, consider the number of visitors who find their way to your church services. A widely used rule of thumb is that the annual total number of visitors should be equal to or greater the average worship service attendance. Thus, a church with an average Sunday attendance of 125 should see at least 125 first-time visitors per year. Another bit of conventional wisdom holds that a church needs to add new people at the rate of 2.5% per year to offset its losses.
Those church visitors are low hanging fruit. They will be the easiest to move into the ranks of the affiliated - into church membership.
Do the metrics indicate your church is on plateau or in decline? If so, isn't about time to give some serious consideration to changing things up to revitalize the church?
3. Ten people selected at random give different statements about the mission and vision.
If the church's core constituents don't voice the same ideas about the church's mission and vision, then one of two conditions exist. Either the pastor has been an unclear and inconsistent communicator about the vision, or there really is not a settled mission and vision at the heart of the church's ministry.
This can lead to a deadly condition in which bitter conflict erupts because people will always fill the "vision vacuum" with their own ideas.
4. Programs, events, and activities are designed for church members.
This is deadly. Smaller churches (less than 200) are especially prone to this. Congregations with limited resources (time, money, space, personnel) must apply those resources to fulfilling the mission and achieving the vision. If the church is aligned around its members, it is living in maintenance mode.
"Maintenance" keeps a church on the downward trajectory - until there's impact at ground zero.
5. Leadership is different from the people you've focused on reaching.
While mature believers are (or should be) comfortable worshipping and ministering with a diverse gathering of believers, such is not the case with unbelievers. The people we would reach with the gospel respond far more readily to the gospel when it is brought to them by others who are like them.
The makeup of a church's leadership team (staff - paid and unpaid, officers, ministry leaders) conveys a subtle message about "the kind of people we are." The team should include people with whom outsiders will comfortably identify. A church three miles from the local university campus should include young adults, perhaps even some university students, on its leadership team. If your church hopes to minister to political refugees from the Congo and Burundi, the public faces of your church should be familiar to them.
A physician friend, now retired, once offered an interesting observation:
If the physician would listen, the patient will generally tell what's wrong with them.
Apparently attentive listening is a skill not widely taught in medical schools or mastered by medical practitioners.
So, as the physician attending to an ailing congregation – what changes do the patient's symptoms call for?