The New Medical tower at Providence Hospital in Everett

Providence Medical Center in Everett (north of Seattle) recently opened an impressive new medical tower, and has been running radio spots touting its impressive emergency room and other services on my favorite news-radio station, KOMO. While I can’t locate the spots online to play for you, the gist is that they spend the first 30 seconds raving about how wonderfully accessible/high-tech/etc the tower is and then… “But without our award-winning staff it’s just a really expensive nifty fancy amazing building” or something to that effect.

While I laud both the effort to offer the highest quality of medical care and the effort to give credit to the caregivers themselves, the ad struck as less than completely true from a sociological perspective. Top specialists and surgeons provide certain skills that are invaluable in the most challenging cases, when diagnosis and treatment can be more challenging than keeping track of the policy violations or wrong decisions in an episode of House. But for the vast majority of patients, it is the culture and sociology of the organization that distinguishes a hospital more than who specifically is doing the treating.

Think about it: when you go into the hospital emergency room (assuming it’s not in an ambulance), is a world-renowned physician ever the first one to treat you? Of course not. Your vitals are often taken by a receptionist, who then hands you off to the triage nurse (after some more waiting), and eventually you get a few minutes with whichever resident or doctor is available to make an initial diagnosis and discuss next steps. Of the 10 or so times my family and I have been to the ER in recent years, only twice has there been need to call in a specialist, once when my wife broke an almost unbreakable bone in her foot and once for an unexplained fever in my newborn.

Every other time, we trusted that, because the hospital adhered to certain standards of treatment, we could safely expect our concerns would be competently addressed. We had no guarantee or knowledge of who would treat us, nor could I tell you the name of a single doctor or nurse from those visits.  When Asher had a fever at 3 days old, we went an extra distance to Children’s Hospital rather than the closest ER because we knew that as an organization they were more experienced at treating infants. By organizing the physical environment, the working conditions, the staff makeup, and the intake and treatment processes around the goal of treating every person as quickly, effectively, and professionally as possible, a good hospital can accomplish its desired outcomes with much more consistency than merely by having good doctors and nurses.  Thus from an organizational theory perspective the administrators probably had a more vital role in ensuring the best treatment for most patients than the individual doctors or nurses.

Why does this matter to ministry? Because congregations tend to focus on the people, particularly in times of conflict. Very often, it means scapegoating a pastor or other staff member for systems of dysfunction and even oppression that have existed for most, if not the entire, life-course of the congregation. The argument becomes not about how to effectively bear the message of the gospel in the world, but about whose fault it is that the church is failing and how to encourage those people to (to put it politely) explore other options.

More often than not, though, it is the fault of a flawed system, combined with demographic reality, that leads churches to perceive that they are struggling or failing. This happens in a number of ways:

  1. Different sizes and locations of congregations face different struggles. For example, small rural churches often have one or more families who essentially have run the church for years and feel that it is both their responsibility and privilege to continue doing so. They do much to perpetuate and fund the ministries that are taken for granted, and in return expect to have tight control over what happens. When demographic shifts in the community lead to increased ethnic and linguistic diversity or to an exodus of young people, they are sometimes unprepared to re-imagine the congregation in ways that address the changing needs.
    By contrast, large program-oriented churches appear to have more than their share of staff conflict. Often, though, the personal conflict is just a mask for broader differences of understanding about the organizations mission and goals. In either situation, it’s easy for staff (and sometimes lay leaders) to get embroiled in conflict, start calling names or worse, and severely distract from the fact that everyone’s goal is really to be a light and provide the good news. Yes, some people want to focus more internally than others, or might prefer Bible study rather than hymn sings, but that doesn’t change the fundamental commonality that can be drawn on.
  2. Over-reliance on a singular measure of success can create the same problem in a different way. Most churches use membership, attendance, and/or baptism rates to gauge success. However, these fail to account for any ministry that is done in the community without the direct outcome of people coming to this particular church, whether it be feeding/clothing housing people who have little transportation to reach you or sharing time with inmates who may be locked up for life and never able to “repay” by darkening your doors.  Discipleship, friendships, and comforting the afflicted also often tend to have less measurable or at least less immediate outcomes.
  3. Failure to attend to both change and stability (i.e. failure to pray without ceasing and trust the Holy Spirit) can have dramatic consequences in any ministry setting.

So today, I invite you and anyone who may have a bone to pick in your congregation to do just a few small things:

  • Stop blaming the pastor, the musician, or anyone else for what you perceive as wrong with your church
  • Start with the assumption that everyone there shares the goal of growing the church and the kingdom of God (or is honestly seeking to find out if there is truth to Christianity, or both)
  • Try and discover what is actually important about a tradition the next time someone says “but we’ve always done it that way” and honor those underpinnings even when things have to change
  • Talk to somebody who’s been part of the congregation forever, someone who’s new, and someone who’s never even been there (but lives locally) before making any major decision about direction
  • Be willing to set aside your agenda and even your ideals but never your values or faith, and only in service of the congregation’s goals and the missio dei
    and finally and most importantly:
  • Pray and pray and pray. Pray that you can love God and others, then stop praying about yourself and pray that God’s name would be honored, that your congregation might reflect her light toward it neighbors, and that you may never get so caught up in this or that person that you forget we are God’s people together

Hospitals rely on their corporate (meaning communal, not business) culture in cultivating excellence. The atmosphere created through managers, coaches, and bonding can turn a group of good or even mediocre ball-players into a team. Listening, honoring our core identities, and fixing our eyes on Jesus (not each others’ flaws) allow us as the church to transform from nerdy, off-key seekers into salt and light.

May you always love first in all things and live faithful to God’s promises and your personal, local, and congregational DNA. Peace.

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