Anatomy of a Sick Church – 10 Symptoms to Watch


There are certain metrics and issues physicians check when we go to the doctor. They want to check our blood pressure and temperature. They do blood tests to see if there are any warning signs. They are looking for symptoms that might indicate real problems exist.

After working with churches for thirty years, I too look for symptoms that might point to greater concerns. The symptoms are not necessarily the problem; they simply provide warnings or cautions of potential issues.

While there are many potential symptoms of a sick church, I have found ten to be consistently common. These ten are not listed in any particular order:

  1. Declining worship attendance. Surprisingly, the majority of church leaders do not monitor worship attendance. I advise leaders to compare each month’s average worship attendance to the same month of previous years.
  2. Decline in frequency of attendance of church members. This symptom is the number one explanation for attendance decline in most churches. Members are not as committed as they once were. Their waning love for their church is reflected in their declining frequency in worship attendance.
  3. Lack of joy and vibrancy in the worship service. Obviously, this symptom is subjective. It is still, however, very important. Most people can sense when a worship service is vibrant, lukewarm, or dead.
  4. Little evangelistic fruit. As a general rule, a healthy church will reach at least one non-Christian for every 20 in worship attendance. A church with a worship attendance of 200, for example, should see at least ten new Christians a year.
  5. Low community impact. In my consultations, I attempt to find clear indicators that a church is making a difference in its respective community. I ask both church leaders and community members for clear examples and indicators.
  6. More meetings than ministry. A sick church will meet about what they should do rather than do it. Some churches have more committees than conversions.
  7. Acrimonious business meetings. Christians can and do disagree. Sick churches have meetings where the disagreements reflect obvious bitterness and anger.
  8. Very few guests in worship services. A vibrant church will attract guests. A sick church will not.
  9. Worship wars. Yes, they still exist in many churches. Those wars are indicators of an inward focus by the members.
  10. Unrealistic expectations of pastoral care. Sick churches view pastors and other staff as hired hands to do all of the work of ministry. Healthy churches view pastors as equippers for the members to do most of the ministry.

None of these symptoms are good, but churches do go through periods where they demonstrate a few of them. The key is to recognize the symptoms and respond early and quickly.

Here is my own subjective health analysis according to the number of symptoms:

1 to 2 symptoms. Normal for most churches for a short period of time. Not an indicator of poor health, but the symptoms should be addressed promptly.

3 to 4 symptoms. The church is sick and needs immediate attention.

5 to 6 symptoms. The church is very sick. If significant changes are not made, the congregation is in danger of moving into the phase of terminal illness.

7 to 10 symptoms. The church is in danger of dying in the next five to ten years. While it is possible for a church to recover from this level of sickness, it is rare. Intervention must be quick, intense, and dramatic. The amount of change necessary is often more than most leaders and members are willing to bear.

Give an honest assessment of your own church by these symptom indicators. What do you see? What should you do if there are a number of symptoms? Let me hear from you.

photo credit: Come in and take a pew via photopin (license)

Posted on June 22, 2015

With nearly 40 years of ministry experience, Thom Rainer has spent a lifetime committed to the growth and health of local churches across North America.
More from Thom

Leave a Reply

Your email address will not be published. Required fields are marked *


  • Anonymous says on

    What if the pastor is the reason there is a sick church? What if there are no elders or deacons to hold him accountable but executive teams? What happens when he chooses not to listen to other opinions? My church fits 5 of these symptoms. I don’t like giving up on family but I don’t know what else to do.

  • Anonymous says on

    What if the pastor is the problem? What if there are no elders or deacons to hold him accountable but executive teams? My church has 5 of these symptoms along with others not mentioned like the pastor is always right and you can’t disagree with him.

  • To add:
    1. Churches with exec staff that overworks support staff but takes no responsibility for spiritual dryness or marital or parental issues among support staff and in fact blames the staff for those issues.
    2. Churches with exec staff that require staff “volunteer” their normal duties.
    3. Churches that insist staff pay for mandated marriage seminars needed because of church staff culture of workaholism.
    4. Churches that do not practice church discipline or practice it unequally across the staff.
    5. Churches that build satellite campuses with little to no plan on how to staff or operate them.
    6. Churches with exec staff that hire support staff under false pretenses – ie. promises of certain positions.
    7. Churches that abruptly initiate or change or stop church wide programs or services with little to no notice.
    8. Churches that consistently burnout volunteers.
    9. Churches that function chiefly as evangelistic organizations to the detriment of other aspects of the role of the local church.
    10. Churches with exec staffs that are effectively “closed loop systems” that do not allow for new ideas and even the proposal of alternative methods.
    11. Churches that do not support missionaries but publically claim that they do.
    12. Churches that are known more for what they are against than what they are for.
    13. Churches with function with a “mission first” mentality at the expense of people and spiritual life.
    14. Churches that emphasize baptism and re-baptism as an emotional response (over and apart from discipleship) while functionally equating it with salvation.
    15. Churches that are dishonest with membership and attendance numbers.
    16. Churches that cater to and promote materialism, consumerism and worldliness.
    17. Churches that discount the need for theological education while demanding it for staff.
    18. Churches that allow unchristian personalities or politicians into their pulpit to speak or use services to interview them in lieu of Scripture reading and a sermon.
    19. Churches that put more energy into drawing a crowd than discipleship.
    20. Churches that claim to be part of the Cooperative Program but allocate less than 1% of their budget to CP giving.
    21. Churches that spend more on their Christmas concert/program than on CP giving.
    22. Churches that are centered around a single personality other than Jesus.
    23. Churches whose staff spend more time event planning than talking to people (other than coworkers) in a given week.
    24. Churches that value what you can produce as it pertains to ministry goals, in terms of numbers, over who you are as a person.
    25. Churches that excuse their own failings.

  • Our little church was started two years ago, in the same building that the pastor had another congregation many years ago, but left to go on the missions field. Before he reopened it, it had sat vacant for two years. Our attendance went up to about 30 members with Sunday am and pm services. The pastor’s son-in-law led Sunday school classes for several months, then he and his family left due to “issues” with another member. Little by little the numbers kept dropping, and we now only have the pastor, his wife, son and daughter-in-law, two grandchildren, my husband and I, another couple who attend very infrequently, and four others who have attended for many years, in whatever form the church took. There is virtually no attendance on Sunday evenings, so they were discontinued. Our pastor is very discouraged, and has suggested we consider selling the large building. There are many repairs needed in the near future, and few to assist. I did your survey, and got six. However, my husband felt led to come to this church, and said he has not felt the Lord wants us elsewhere. Any thoughts?

  • Carmen S. says on

    Dr. Rainer,

    Have you ever addressed one of the main reasons for people leaving the churches? The “Dones” aren’t done with loving Christ, but they are done with sweeping under the carpet domestic abuse, child abuse, sexual abuse and spiritual abuse.

  • Anonymous says on

    Along these same lines…. I would like to see a blog post on how to leave a
    Church gracefully. Especially when pushed out.

  • It has been my experience, that some church leaders, refuse to speak on sensitive subjects, such as homosexuality. One pastor I talked to, considers it a ‘gray’ area and should be left alone. Preachers, in my opinion, need to tell it like it is !

    • And live it like it is! If we can’t communicate our needs, our joys, our concerns, our ideas with one another, changes will not happen. Sometimes we just need to shake the dust off of our sandles and move on….

  • Johnny Medina says on

    What about love and obedience to the scriptures?
    What about your love for God as evident by your love for people?
    What about preaching of the gospel or good news according to Jesus and the New Testament writers?
    What about following the example of what church and fellowship means as show in Acts 2?
    What about repentance, baptism, turning to God and then maturity?
    What about grace, forgiveness and faith?

  • Great article Thom!
    I came across a sermom by Talmage today intitled “The Battle of the Pitchers.” He says at one point (states it much more harshly and bluntly than I would), “I think of the ten millions membership of the Christian church today, if five millions of the names were off the books, the Church would be stronger. You know that the more cowards and drones there are in any army the weaker it is. I would rather have 300 picked men of Gideon than the twenty-two thousand unsifted host. How many Christians there are standing in the way of all progress! I think it is the duty of the Church of God to ride over them, and the quicker it does it the quicker it does its duty.” OUCH!

  • Mark Crabtree says on

    I have just taken the pastorate of a church in Montana and have only been here for 4 months, but interestingly I have seen the things mentioned in this article as the reason why that this church has not been increasing. I have also seen that if I want to make changes there is some push back due to the fact that they have always done”done it that way”. I pastored a church previously with the same condition and frankly became woreout and frustrated with the lack of interest. How long to stay in a place with this attitude is the question. To continue on with the same situation being the norm will mean sure death for the church as a whole and the individual in spirit.

  • I think I wind up at least scanning most of your fb posts and am happy to say it is usually to confirm my thinking/opinions about the church I am called to pastor, how we/I am doing etc. I am blessed to say the church I pastor got a zero

  • Christine says on

    I am curious as to what percentage breakdown you’d guesstimate for each level. For example, what percentage of churches do you encounter that really only score 1-2? Your list seems perfectly reasonable but I struggle to think of more than a couple of churches in my denomination that have fewer than 3 of these issues going on at any given time. In our denominational context, anything under 5 would be considered “pretty good” or “stable.” Do you think our standards are just unreasonably low? Is everyone else doing better?