Audio Transcript

The weekend is over. We’re back to work, and back to work thinking about work — particularly how we can be most fruitful by leaning on strong administrative structures that we need in place. We’ve never talked about this angle of leadership on the podcast. So it should be interesting. How do we build the structures we need so that we can fulfill our calling in the world?

The topic is relevant for ministries and relevant for Christian business leaders and relevant for health-care providers too. In fact, today’s question comes from a doctor, who writes this: “Dear Pastor John, I’ve greatly enjoyed Ask Pastor John over the years. Thank you for blessing and strengthening my faith in Jesus Christ. My question is this. I’m a doctor. I’ve tried to live and serve by 1 Peter 4:10–11. However, I’m also the practice owner. My family and our two dozen employees and their families all financially depend on the profitability of our practice. Increasingly, I find my thoughts and efforts consumed by the profit-seeking aspects of running a business. Biblically, is there a way for me to reconcile a God-honoring attention to patient care with my responsibility as a business owner to generate a profit so that employees can provide for their families?” Pastor John, what would you say to this doctor?

The answer to that last question is yes, there is a way to reconcile a God-honoring attention to patient care with the responsibility of the clinic owner to manage the affairs of the clinic in such a way that it remains financially viable — that is, remains in existence. It may be that you don’t need to talk primarily in categories of care versus profit, but maybe in the categories of clinic existence and clinic care.

Two Kinds of Care

In other words, perhaps the way to think of these two sides of the clinic’s life is that there are two kinds of care, not care versus something else, but two kinds of care that one must attend to in order for patients to be helped. One is the immediate care of diagnosis and treatment for all the maladies that people come to the clinic with, and the other kind of care is to see to it that the very possibility of diagnosis and treatment exists — namely, a clinic with doctors and the resources they require to do the healing work they’re called to do. These are really two forms of caring, aren’t they?

Now, admittedly, the one is more immediate and feels more like care, because the doctor or the nurse is sitting face to face with a sick patient and talking about how healing might be pursued. But if there were no clinic to come to, and no doctors and nurses and laboratory staff to follow through with, the diagnosis and the treatment wouldn’t have any effect, or they wouldn’t even happen.

So the more immediate care is dependent on the more general, broad, behind-the-scenes care, the business side of the clinic, which must take into account costs of rent, and utilities, and upkeep, and sophisticated medical devices, and receptionists, and scheduling, and insurance reports, and computer support, et cetera. One can feel why our friend would begin to feel submerged under that kind of demand, but they really are two essential forms of caregiving, even if it’s less direct in one way and more direct in another. If the clinic goes out of existence because of poor management, poor pricing structures, poor collections, poor planning for patient load, everyone suffers and care ceases.

Trellis Work, Vine Work

So let me say a word to the actual inner struggle the doctor is feeling as he wrestles with these two kinds of care. He says, “Increasingly, I find my thoughts and efforts consumed by the profit-seeking aspects of running a business.” Now, how many pastors, how many educators, teachers, how many leaders of inner-city ministries have felt this very same sense of being consumed by the financial and structural demands that undergird a ministry, on the one hand, while they long to be doing face-to-face, actual ministry or teaching or counseling to people, on the other hand? There’s nothing unique, it seems to me, about a medical practice in that kind of struggle. This is true of churches. It’s true of schools. It’s true of all kinds of ministries.

For example, a book was published some years ago by Colin Marshall and Tony Payne called The Trellis and the Vine. The description of the point of the book goes like this:

All Christian ministry [and you could say the same thing about a lot of secular service providers, I’m sure] is a mixture of trellis and vine. There is vine work: the prayerful preaching and teaching of the word of God to see people converted and to grow to maturity as disciples of Christ. . . . And there is trellis work: creating and maintaining the physical and organizational structures and programs that support the vine work and its growth.

And then the authors ask, “Has trellis work taken over for you in your ministry? Has it begun to consume you?” They say it does have the habit of doing that.

In Acts 6:1–7, the apostles were about to be overwhelmed, consumed by the demands of trellis work (providing the personnel and structures for the distribution of the food among the widows) when they needed to be giving themselves to the vine work of the word of God and prayer. And the remedy for that was the putting in place of gifted people who were really good at trellis work in order to free the apostles to do the vine work that they were called to do.

“The diversity of gifts for maintaining the viability of a clinic or a church or a school or a ministry is crucial.”

I recall, very personally, when our church got to a certain size, and I was about to be consumed, overwhelmed as the lead pastor, and we put in place for the first time in the history of the church an executive pastor alongside me, and that resulted, I would say, in twenty more years of flourishing as a staff and church. And then, eventually, we put in place financial specialists, who could handle all kinds of complex workings behind the scenes of a growing church, and so on.

All Christian ministry, and even secular service providers, is a mixture of trellis and vine. There’s vine work: hands-on, face-to-face meeting of people’s needs. And there’s trellis work: creating, maintaining the financial and organizational structures that support the vine work.

Four Words of Encouragement

So maybe I could sum up my counsel to this beleaguered doctor with four statements.

First, view both the trellis work and the vine work — the financial, structural work, and the diagnostic and treatment of patients face to face — as two kinds of love, two kinds of care.

Second, put in place gifted people who are really good at the kind of business management your clinic requires in order to free up medical staff to do their more immediate care. This is right at the heart of what Peter was saying in 1 Peter 4:10: “As each has received a gift, use it to serve one another, as good stewards of God’s varied grace.” The diversity of gifts for maintaining the viability of a clinic or a church or a school or a ministry is crucial. Pray that God would lead really gifted people to do the kind of specialized tasks that a complicated clinic — or business or ministry — requires.

“God will not honor the cutting of corners, the loss of integrity, in order to do good.”

Third, don’t ever do evil that good may come (Romans 3:8). That is, don’t try to justify dishonest business practices because they will keep the clinic alive for the sake of love, for the sake of patients and employees. God will not honor the cutting of corners, the loss of integrity, in order to do good. There’s always a way to help people by doing the right thing.

And finally, I would say, God has promised — he really has, and he keeps this promise — in Philippians 4:19 to meet all our needs “according to his riches in glory in Christ Jesus.” Trust him. Trust him to do that, and roll the burden that you feel for the complex side of this clinic — roll that burden onto the Lord. George Müller, who had to keep an infrastructure running to maintain thousands of orphans, used to say when people asked him about his peacefulness, “I rolled sixty burdens onto the Lord in prayer this morning.” I love that. I want to be like that.

So, God bless you for bearing the burden of a medical clinic that serves both patients and employees, both by its immediate medical care and by its trellis-like financial viability. May God give you the wisdom and the grace to put the people and the structures in place that enable you to do what you love to do and so find everybody flourishing in that great work.

http://rss.desiringgod.org/link/10732/15387138/sex-money-praise-power-no

A man sat along the road where one path broke into ten. A deep fog rested upon the land so no traveler could perceive each path’s end.

The man’s King, before going off to his kingdom, told the man the end of each. One path led to a den of lions. One to a cliff with jagged rocks at the bottom. One through a forest with bloodthirsty beasts. Another to a swamp with inescapable quicksand. Still another to a tribe of cannibals. And the unsavory reports continued in this fashion. Only one led to the King’s kingdom. His charge was simple: warn others away from destruction and toward the path of life.

A young man first crossed his path. “My friend, I have good news for you,” he said to the traveler. “The King of this world sent me to help you along. This path here, of the ten before you, alone is safe. And not only safe, but it leads directly to the King and his kingdom — a kingdom where you will be received, robed, and reconciled by his incredible mercy. The other paths — as the King has most solemnly recorded in his book — lead to certain ruin.”

To his amazement, the passerby completely ignored his pleadings. A woman upon his arm held his ear, bidding him to follow another of the ten paths. “Sir! Come back! That way is the path of death! Come back!” he cried until the man faded from sight. The servant sat down in silence for hours. What should I have done differently?

The second traveler, this time a young woman, paused momentarily to hear what he had to say. She considered the prescribed way, saw it was both narrow and hard, and without much more thought chose against it, telling him not to worry; she would be fine.

The sight of the next travelers forced the horror of that woman’s end from his mind. A husband and wife approached (hardly speaking or looking at one another). This couple, as self-confident as they were unhappy, met his royal invitations with a sharp rebuke.

“‘But what will they think of me?’ has lodged the name of Christ in many throats.”

“Barbarously arrogant!” the woman scolded.

“Hypocritical and judgmental,” the husband added.

“Love,” the woman said without stopping, “lets others travel their own path for themselves by themselves, and does not force one’s own way upon anyone.”

He tried to tell the back of their heads that it was not his way but the King’s, yet they paid no mind. Hand in hand, they walked toward the cliff, mocking such a fool upon the road.

Days went by after this fashion. Each encounter weakened his pleadings. The mission that he began with a royal sense of privilege soon waned into callousness, confusion, and apathy. Family, friends, colleagues, and strangers now pass by, all stepping upon their chosen path. He gives but a feeble smile at the unsuspecting people who embark upon their preferred way to perdition.

Weary in Speaking Good

I have felt like this servant of the King.

I have often asked with Isaiah, “Who has believed what he has heard from us? And to whom has the arm of the Lord been revealed?” (Isaiah 53:1) The temptation to compromise finds me in my defeat, whispering, “Is it really worth it?” or, “Did God really say that the gospel is the power of God for salvation?”

Add to this whisper the fleshly impulse to avoid conversations that can easily lead to awkwardness or rejection. Some of us, myself included, heed the voice telling us that “going there” is neither polite nor promising, rather than the voice telling us to share the only name given under heaven by which they must be saved (Acts 4:12). But what will they think of me? has lodged the name of Christ in many throats.

Now add to these challenges the sweet words in our day about “tolerance” — words that regularly convince Christians to consent to compromise while person after person passes by on the road to ruin. While Jesus didn’t blush to tell people that he alone was the way, the truth, and the life (John 14:6), we often fail to pass along the life-saving message we have been given.

Word to Passersby

If you are considering which path to take and desire the King’s perspective, here you have it: Jesus alone is the way, the truth, the life; he alone is the mediator between God and man (1 Timothy 2:5); he alone brings reconciliation to sinners (Colossians 1:20); he alone reveals God perfectly (Hebrews 1:3); he alone is the resurrection and the life (John 11:25); there is salvation in no one else (Acts 4:12). Two types of paths exist: the way of Christ, and the ways of condemnation (Matthew 7:13). Every path not leading to repentance and faith in Jesus for the forgiveness of sins is a path leading to never-ending death.

God sent his Son into the world of condemned criminals in order to save it and give eternal life to all who believe (John 3:16–18). Jesus is the one name offered to you for your salvation. He is the only one who can take away your sins. Your good works will not spare you; your good character will not shelter you; your good intentions will not clothe your nakedness. The angel of death walks outside; only the door with Christ’s blood painted on the frame can shelter you.

“Two types of paths exist: the way of Christ, and the way of condemnation.”

Consider your path before it is too late. Not choosing a path is a path. Believing that no true paths exist is itself a path. Secularism, materialism, and false religions have paths. Contrast these with the only one that can lead to life, that of Jesus Christ and his gospel.

Politically correct? No. Tolerant? No. Exclusive? Assuredly. Loving? Absolutely. “God shows his love for us in that while we were still sinners, Christ died for us” (Romans 5:8). Will you be a part of the us?

Plea to Christians

If, on the other hand, you are one of the many men or women at the crossroads, charged by the King to warn and to guide, do not give in or give up; the world needs your voice. Do not bow to the hollow statue that the world has erected and named “Love.” Compromise is love only with respect to self and sin, tolerant only toward the masses going to hell, and accepting only of a cowardice that makes us complicit in condemning those we claim to love.

If we believe our King, we cannot sit silently. If we care for souls, we cannot grow mute. If we love our God’s glory, we must speak. We cannot watch family, friends, and even enemies pass by with indifference.

In Due Season

Eventually, this servant of the King, through considering his own relationship with the King and meditating on the words of his book, revived his trust in the King’s message.

An old man made his way slowly toward him.

“Sir, I have wonderful news for you — and I hope, I pray you receive it. My King has sent me with an urgent message that you, even in your old age, can find eternal life. This path, sir, though hard and with a narrow gate, is the singular path to life. Every other has something worse than death inscribed upon it. Even now, my King awaits, ready to receive you.”

“Why should such a King offer me such a welcome?”

“Because, in his great love, he has made a way — through highest payment to himself — to receive all who come to him in faith. . . . Yes, even you. . . . Yes, that is his promise. . . . Yes, this path.”

Do not give in. Do not give up. Keep praying for your child; keep speaking the truth in love to that neighbor; keep pointing to Jesus Christ. Do not grow weary of speaking good, for in due season you will reap, if you do not give up (Galatians 6:9).