In the health industry there is something called a clinical gap. A clinical gap is an area of medicine or a segment of the population for which no treatment is available or for which the treatment that is available is subpar. Clinicians (the ground troops of medicine) identify a clinical gap as a patient group that has no optimal solution to their problem. As an example, consider a man who can hardly walk due to an arthritic knee. His doctor presents him with two options: take pain medication or get a knee replacement. Ideally, a third treatment would be available such as artificial cartilage or a stem cell implant; however, this alternative is still hidden away in university research labs.
What should the man do? The pain medication is not a real solution to the problem; it deals with the symptom, but not the cause. The knee replacement is a genuine remedy, but this procedure might very well be unattainable due to costs involved or gaps in insurance coverage. The man is stuck within a clinical gap. Sadly, the best treatment within reach might end up being a cheap knee brace from Walgreens and a bottle of Advil.
The idea of a clinical gap is useful for understanding the spiritual plight of contemporary men. Allow me to create the hypothetical example of Steve, a 30 year-old Christian who lives in Slidell, Louisiana. Steve has been a Christian for several years and has an unusual appetite for spiritual growth. Now if Slidell is a typical midsized American town, what are the discipleship options that will be available to Steve?
On the one hand, the obvious answer is the gamut of local church ministries. Some of these churches will be blatantly consumeristic in outlook and have no appeal for anyone genuinely interested in discipleship. But, these aside, there will be other churches intentionally pursuing the Great Commission and offering a carefully crafted menu of groups and events designed to mature Christians in their faith. These churches will offer congregational worship, informal small groups, mission events, Bible studies, and so on. Seemingly, Steve could get plugged into any of these churches and, so long as he was earnest in his desire for spiritual growth, would receive all of the support needed to mature.
Yet this optimism must be checked by a degree of realism. No doubt, Steve could easily find an expository sermon, a midweek study, a group of men to fellowship with, and an occasional service project or mission trip to join. However, we need to ask a prickly question: what if this menu is not enough? What if more is required than the formula offered by typical churches in order to produce daring faith, resolute vocation, gospel witness, holy character, and spiritual camaraderie? The truth is that there is not a lot of creativity on the ground among churches. Most are offering a different version of the same thing. Is the recipe adequate? I would argue that something is missing. What is the evidence of this? The fact that men are not developing into spiritual leaders.
So bear with me. Let’s say for the sake of the argument that even after diligently taking notes during Sunday sermons, after joining a Wednesday night life group, and after attending men’s gatherings as frequently as they occur Steve realizes that he needs more. In Slidell, Louisiana what will be the next option available to him?
Seminary is one answer. We can imagine that over lunch breaks Steve begins to explore the websites of various seminaries and Bible Colleges. At first, the thought of dedicating multiple years to fulltime study among likeminded Christians is exhilarating. But then Steve is reminded of the mortgage on his house, the needs of his wife and two children, the paycheck that comes monthly in the mail, and the fact that he barely scraped through high school English. In addition, Steve has met enough seminary graduates to know that formal study is no guarantee of wisdom or godliness. Thus, without losing much sleep, Steve concludes that seminary is not for him.
This door closed, what, then, is the third option for Steve? Here we bump against the clinical gap that affects countless Christian men today. For too many guys no clear option exists between the comfortable routine of a local church and the drastic upheaval of enrolling at seminary. This problem may not exist for guys living in Dallas, Grand Rapids, or Colorado Springs, spiritual hubs where every parachurch ministry is as readily available as a MacDonald’s or Burger King. But Steve lives in Slidell. Certainly he can read more books or tune in to further ministry via the internet. Yet such conditions are unideal. The Christian life is not meant to be pursued in isolation. The Christian life is supposed to be a life together.
We need to appreciate the degree to which men are affected by the conditions in which they live. Human beings are social animals. We conform to the practices, passions, ideals, and goals of our environment. The secular world is well aware of this. The success and effectiveness of a gym franchise like CrossFit is due as much to culture as to clarity. The difference between joining CrossFit and Planet Fitness is far greater than the benefit of a clear work plan. At CrossFit, gym members become immersed in a community of joint aspiration and shared practices. This environment feeds motivation and nudges men and women down the path to physical fitness.
Why am I saying this? The example of CrossFit sheds light on the spiritual needs of men. In the book Switch the authors make the point that often what looks like a personal problem is a situational problem. Church leaders need to ponder this truth as they plan their discipleship ministries. What does Steve need? What would fill the clinical gap for him? He needs a discipleship community with the focus, earnestness, and camaraderie of a CrossFit gym. Without claiming that this is the only aspect of the problem, or even the most important one, we need to admit that one reason why guys are falling short of their spiritual potential is because they live in a spiritually arid environment. There is good reason to believe that a guy like Steve would flourish within the spiritual conditions of early Methodism or of the house church movement in China. But Steve lives in suburban America where the spiritual thermostat of most congregations is set at a comfortable 72 degrees. Sadly, unless Steve is doggedly vigilant, this setting will lower the bar of his spiritual ambition. He will eventually settle for less because he doesn’t realize there is more.
One of the most frustrating aspects of clinical gaps is that often the technology needed to help people is available in the research labs. In many cases the problem is not one of discovery but one of supply. A bridge needs to be built to enable the benefits of the lab to help ordinary people on the street. This is certainly the case with regard to discipleship. New theory does not need to be developed in order to help men grow. All of the wisdom of the Bible has been distilled and rehearsed countless times on the stage of history and through the printing of books. The difficulty is taking this wisdom and using it to reform ministries at a local level. Until this happens, too many men will be stuck in the gap.