Military supervisors wield more power than civilian ones; they are authorized to enforce rules that govern even the size of earrings a doctor can wear. Stepping out of line can be perilous for subordinates: One former Army radiologist said her supervisor threatened to transfer her to an outpost so remote that the only housing was in trailers.

“In the military you are not taught to question; you are taught to obey. And that’s great on the battlefield,” said Bill Benham, until recently first sergeant of the hospital at Fort Knox in Kentucky. “But health care is another beast.”

Risk in Raising Concerns

An analysis of military hospital data by The Times this year found preventable errors are chronic and rates of complications, when measured, are high in two cornerstones of treatment, maternity care and surgery. The Times also found that hospitals routinely failed to investigate after patients died unexpectedly or suffered permanent harm.

The Pentagon’s own review, ordered in May by Defense Secretary Chuck Hagel, resulted in orders for improvements at almost every hospital. Pentagon officials said they were especially concerned by suggestions of a systemwide shortcoming: medical workers’ reluctance to identify problems.

More than a dozen physicians and nurses interviewed for this article said their own experiences illustrated why. Most insisted on anonymity for fear of further harm to their careers.

A former military surgeon at Womack said he was passed over for promotion after he said that his supervisor had failed to properly examine a patient who later died of cancer. A psychiatrist who worked at Wright-Patterson Air Force Base in Ohio said her supervisor tried to oust her after she complained that residents were not properly supervised. A former anesthesiologist at San Antonio Military Medical Center said his supervisor initiated a review of his credentials after he questioned why she failed to insert a breathing tube in a patient who later died and why another doctor gave the wrong type of blood to a patient.

Dr. Russell Hicks, a psychiatrist, said Madigan Army Medical Center outside Tacoma, Wash., revoked his credentials this year after he identified serious flaws in a program to screen soldiers for post-traumatic stress. “I did what I knew, and I still know, was right, and they went after me,” he said. He has appealed the decision.