Spiritual Malpractice: When Elders Neglect the Health of the Church

Over the course of my ministry, one of the most common leadership problems I have encountered is also one of the most dangerous, because it rarely announces itself as a problem.

Most church problems do announce themselves.

Attendance is declining. The church is aging. There are not enough children. There are not enough volunteers to keep programs going. A beloved ministry has been changed or eliminated. Someone is angry about something the pastor said. Giving is down. The building needs work. The calendar is too full. The pews are too empty.

These are the kinds of problems that get attention because they are visible. They can be counted, named, and complained about.

But one of the great difficulties of church leadership is that what presents itself as the problem does not always tell us whether it is the actual problem or merely a symptom of something deeper.

When I think about symptoms, I think of doctors and nurses, or maybe medical shows on TV. (And, by the way, how is Grey’s Anatomy still on television???)

One of my favorites was House. The premise of the show revolved around a pill-popping doctor who was brilliant at diagnosing what everyone else missed. Much of the show centered on his team working through a differential diagnosis. They would identify symptoms, test possibilities, get things wrong, eliminate false leads, and eventually discover the underlying illness.

That kind of work required quick thinking, a cool head, strong medical knowledge, and the willingness to be wrong a whole lot along the way.

There is more overlap between that work and the work of church elders than we may first realize.

An elder needs to be mentally sharp. Elders need to discern what is actually going on beneath the surface of congregational life. They need to ask whether what they are seeing is the problem itself or the symptom of a deeper spiritual issue.

An elder also needs to keep anxiety in check. In congregational life, anxiety spreads quickly. A disappointed member, a declining budget, a tense meeting, a shrinking program, or an angry email can easily hijack the attention of the whole leadership body. Elders need the maturity to think clearly even when others are upset.

And elders need a strong command of Scripture and theology. They are not merely organizational managers. They are spiritual leaders. Their work requires biblical imagination, theological depth, prayerful discernment, and wisdom.

With these skills, elders can guide a congregation well. They can help the church know what matters and what does not. They can help distinguish between what is urgent and what is truly important.

That is the work of discernment.

The problem is that, in the anxiety of congregational decline, everything begins to present itself as urgent and important. The attendance numbers matter. The children’s ministry matters. The building matters. The budget matters. The upset people matter.

And because those things are visible, elders can easily begin to chase them without ever asking whether they are looking at symptoms or causes.

In anxious seasons, churches often become obsessed with what they can see and count. In traditional parlance, these are the ABCs of church life: attendance, buildings, and contributions.

Those things are not unimportant. Attendance tells us something. Buildings matter because they are tools for ministry. Contributions matter because money is one of the ways people participate in the mission of the church.

But are these the actual goals?

We count what matters. We count the money in our bank accounts. We assess the value of our homes. We count attendance, giving, square footage, volunteers, and views.

But is that what Jesus called his church to attend to first?

Jesus said he came to seek and save the lost. He came to call sinners. He came that we might have life. He came to proclaim good news to the poor, release to the captives, recovery of sight to the blind, and freedom for the oppressed.

If those are the concerns of Jesus, then they must become the concerns of the church.

And if they are the concerns of the church, then they must become the concerns of the church’s elders.

The primary calling of elders is not to oversee attendance, buildings, and checkbooks. Those things may be part of the work, but they are not the center of the work.

The primary calling of elders is spiritual oversight.

Elders are called to look after the spiritual health of the people entrusted to their care. They are called to nurture faith, guard the flock, equip the saints, discern what is happening beneath the surface, and help the people of God participate in the mission of God.

To do less is to become like the fig tree Jesus cursed when he was hungry. From a distance, the tree gave the appearance of life. Its leaves promised fruit. But when Jesus came near, there was nothing there.

A church can do the same.

A church can have activity without fruit. It can have programs without formation. It can have buildings without refuge. It can have attendance without discipleship. It can have committees without mission. It can have giving without gospel renewal.

A church that does not offer the hope and healing of the gospel is a spiritual refuge that offers no shelter.

And elders who neglect the spiritual nurture of those entrusted to their care are like guides who do not know the trails they claim to lead.

More directly, elders who neglect spiritual nurture are committing spiritual malpractice.

That may sound strong, but I think it is warranted.

People can attend all kinds of events. They can enter all kinds of buildings. They can give money to all kinds of causes. They can join all kinds of organizations.

Only the gospel of Jesus Christ can offer true hope to weary and parched souls.

So elders must put first things first. They must look after the spiritual health of the congregation in their care.

But how?

1. Elders must commit themselves to the work of spiritual care

Spiritual oversight does not happen by accident.

If elders do not intentionally commit themselves to this work, it will almost certainly be swallowed by the urgent demands of congregational life. The budget will need attention. The building will need repair. The programs will need volunteers. The calendar will need decisions. The complaints will need responses.

Those things will always be there.

But if elders are not careful, they will spend all their time managing the institutional machinery of the church while neglecting the spiritual life of the people.

That is why elders need to make a clear commitment together. They need to covenant with one another that spiritual care is not an occasional add-on to their work. It is the heart of their work.

This also means recognizing the difference between pastoral care and spiritual care.

Pastoral care often involves applying grace and compassion in moments of loss, crisis, pain, or failure. It is sitting with the grieving. It is praying with the sick. It is walking with people through suffering.

Spiritual care includes that, but it is broader. Spiritual care looks for the maturation of the people of God. It asks whether people are growing spiritually, emotionally, mentally, and relationally into the likeness of Christ. It asks whether the church is helping people become more faithful disciples in the places where they actually live, work, serve, and love.

This work will not happen accidentally.

Elders must choose it.

2. Elders must assess the spiritual health of the congregation

It is good for elders to know what is happening among the people they lead.

• Are the people of the congregation growing more and more like Jesus?

• How are they growing?

• Where is there evidence of love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, and self-control?

• Where is there evidence of spiritual stagnation?

• Where is there anxiety, bitterness, fear, cynicism, apathy, consumerism, or self-protection?

This kind of assessment can make church leaders uncomfortable. One common objection is, “It is not my place to judge.”

Of course, elders should not be harsh, arrogant, condemning, or self-righteous. But the work of discernment is not the same thing as judgmentalism.

It is the place of elders to discern. It is the place of elders to equip. It is the place of elders to protect. It is the place of elders to ask whether the people under their care are being formed in Christ.

Hiding behind “do not judge” language may sound humble, but it can also become an excuse for avoiding the actual work of spiritual leadership.

Elders are not called to inspect the congregation with suspicion. They are called to tend the congregation with love.

But loving oversight requires paying attention.

3. Elders must assess the church’s ministries

Elders also need to ask hard questions about the ministries of the church.

• Are these ministries helping people think, act, and become more like Jesus?

• Were they designed to do that?

• What kind of people are these ministries forming?

• What fruit are they producing?

This is often where elders begin to stretch the truth. A beloved ministry may have existed for decades. A program may have strong emotional attachment. A particular event may be part of the congregation’s identity.

So when someone asks, “Is this actually helping people grow as disciples of Jesus?” the temptation is to make the answer fit what we already want to keep.

But elders have to be honest.

Results are not everything, but they do matter. Fruit matters. Direction matters. Formation matters.

If a ministry was never designed to form people in Christ, then any spiritual growth it produces may be accidental.

That does not necessarily mean the ministry should be eliminated. But it does mean elders need to tell the truth about what the ministry is doing and what it is not doing.

A church does not become faithful by preserving every activity that once mattered.

A church becomes faithful by continually surrendering its life and work to the mission of Jesus Christ.

4. Elders must learn from other elders

One of the unfortunate effects of denominationalism, especially in America, is that churches often behave as though they are in competition with one another.

We have our side. They have theirs.

We have our church. They have theirs.

We have our programs, our people, our territory, our traditions, our anxieties.

But that was never meant to be the spirit of the church.

Elders are called to care for the particular flock entrusted to them, but they are also part of the broader body of Christ. That means elders should be willing to learn from other elders and other churches.

Find churches whose elders take spiritual oversight seriously. Ask what they do. Ask what they measure. Ask what they talk about in meetings. Ask how they pray. Ask how they assess spiritual growth. Ask how they handle conflict. Ask how they keep from being consumed by institutional maintenance.

Elders need to become better at asking other elders for help.

This is not a sign of weakness. It is a sign of humility and maturity.

Putting first things first

In all of this, it is hard not to think about Jesus’ parable of the talents.

Too often, churches bury the gifts entrusted to them. They become too timid, too anxious, or too distracted to take up the work of cultivating spiritually mature people and spiritually healthy congregations.

But the church has been given a mission. And it is not ours to redefine.

God is reconciling all things to himself through the blood of Jesus Christ. God is renewing a creation broken by sin. God is calling sinners to life. God is forming a people who bear witness to his kingdom in the world.

That is the mission.

The church does not exist to maintain itself.

The church exists to participate in the redeeming work of God.

That means elders must resist the temptation to make visible institutional concerns the center of their work. Attendance, buildings, and contributions matter, but they are not the heart of the church’s calling.

Spiritual oversight is.

The first concern of elders must be the spiritual health of the people entrusted to their care.

When elders remember this, they help the church recover its true vocation. They help the church become more than a busy institution. They help it become a community of people being formed in Christ for the sake of the world.

That is the work.

And it is too important to neglect.