Philip Martin Rosoff, an emeritus professor at Duke University School of Medicine who headed the hospital ethics committee there, said that hospitals had become more corporate over the decades and that their executives consequently had the same impulses as other executives to “control the narrative.” However, he said, hospital officials have other reasons to be wary of doctors and nurses who take matters into their own hands, such as patient safety. He cited the refusal of some surgeons to treat H.I.V.-positive patients at the height of the AIDS epidemic.

Perhaps nowhere is the friction between health workers and management more palpable than in the New York area.

Health systems including Northwell Health, NewYork-Presbyterian Hospital and Montefiore Medical Center have barred workers from speaking to reporters, though not always with the explicit threat of termination.

“Do not respond or speak to any reporters, as well as current or former employees, regarding a pending news story,” wrote David A. Feinberg, the chief marketing and communications officer at the Mount Sinai Health System, in an email to all faculty and students on March 26. Mount Sinai has more than 40,000 employees.

There has been internal dissent as well. Tasha Smith, a Mount Sinai nurse, said she had been fired after complaining to her boss that she was uncomfortable treating coronavirus patients without proper equipment, and said she had brought a doctor’s note attesting to her anxiety. Mount Sinai said in a statement that Ms. Smith had been fired ​because “without any notice, she walked off the job.” It also said it always provided its medical staff with the equipment needed “to safely do their job.”

Ms. Smith, who had worked at the hospital for three years, said the abrupt firing frightened fellow nurses. “They’re afraid to speak up,” she said. “I was made an example of.”

On Friday, several New York City Council members announced plans for legislation to prohibit firing health care workers for speaking publicly about hospital conditions.