The consequence of wasting a doctor or ambulance drivers time is depriving someone else of medical care, potentially leading to worse medical outcomes, up to death.

I’m sure you’re going to pose a hypothetical that you would be in the way to save someone’s life, but we both know that’s not true and even in that situation, you could raise that with the train company rather than faking a new, different medical emergency

I won't give you a new hypothetical, just complete the comparison.

It's true an EMS call might reduce QALY (quality adjusted life years). It's also true that taking a train full of passengers somewhere they don't want to go also reduces QALY.

Iterate this enough and DB changes their policy. Now we have a new equilibrium. The full game theory of this isn't as simple as wasted doctor time = bad.