MacDonald pastors in the Chicago area and throughout the book is very transparent about his own failures and trials. His tone thus never really comes across as a smug instruction manual on how to build a successful church. In fact, he time and time again proposes the notion that growing a church in and of itself is not and should not be the goal of a church. Instead, a church should seek to be the healing and hope its community needs by recognizing that this only done by bringing people into the presence of God.
MacDonald describes the modern church as being "horizontal" instead of "vertical." A vertical focused church is one who focuses on worshiping the Lord, getting into His presence, and inviting His glory down in the services and the way lives are lived throughout the week. For MacDonald, all evangelism, engaging, discipleship, and more flows naturally from the hearts of those who are firstly seeking the glory of God and His presence in their lives. MacDonald offers his theory though that churches have settled for the horizontal, that is, they have focused on doing ministry and having church and getting results while neglecting the presence and glory of God.
MacDonald speaks to this throughout the book, but especially in the notion of trying to overly appeal to culture and individuals who have no desire for church. He points out that Jesus said that He would do the drawing of all men if we would only lift Him up. He reminds the reader that it is the Holy Spirit that actually does the convicting and the saving, not ourselves. MacDonald warns that churches have become more synonymous with self-help / emotional experiences than the glory of God. He argues from Ecclesiastes that all people are created with a sense of eternity, that is, there is a God and we are not Him. People who recognize that they can't fix themselves and who then show up in church, don't need 12 steps. They need to be impacted by the presence of the Lord. Our churches have claimed to have something that is not very visible and active and thus churches are closing and dying.
Going throughout several ministries in the church, MacDonald speaks to how different ministries can safeguard themselves from becoming "me-centered" and "culturally relevant" at the expense of the glory of God. MacDonald challenges the reader to forsake trying to be all things to all people and to instead learn to seek God in all things and stop trying to do His work and His ministry in our own strength. Even if we accomplish some things, MacDonald argues that the effects will be marginal at best.
I would highly recommend this book to all who are in ministry. It's a tough read in some places and you may not completely agree with everything he says, but he's right on the money as it pertains to his "vertical v. horizontal" approach of doing ministry in the church.