Just for info here's what I wrote about MF digital cameras back in 2012:
A reader of the VSL blog recently wrote to suggest, after reading my post about photographing Lou with my film Hasselblad, that I try out a medium format digital camera before making the assessment about which path will ultimately yield better results. I thought I would remind my readers that I've been down that road before, for months at a time, and with three different systems. In 2009 and 2010 Studio Photographer Magazine commissioned me to test and write about three of the MF digital cameras that were just coming on to the market. My two most memorable tests were of the Leaf AFi7 with a 39 megapixel back and the Phase One 45+ because, at the time, they were the state of the art.
I also reviewed the less expensive Mamiya entry MF digital camera.
Once you got over the fact that you'd just signed for a $45,000 system (when the two delivered lenses are factored in) the Leaf camera was nice. It made beautiful files. The 180mm f2.8 Schneider lens was superb. It gave really nice out of focus performance and even better in focus performance. But it's autofocus was slow like paint drying and the tandem batteries in the camera and grip did their best to die often, and always out of sync. Would I still be shooting with the camera if someone bestowed it upon me for free? Yes. Was the calculus there for me to buy it and make more money with it? No.
The Phase One was as close to being the perfect medium format digital system I've shot with so far. The camera is much lighter and better set up than the Leaf and the lenses+body were small enough and light enough to be used handheld and to be carried around town.
The Mamiya was heading in the right direction price wise and I thought the files were just fine.
But with each of these cameras I kept coming back to the idea that I could dump the $25,000 or more into film and processing with cameras I already owned and get files that were just as good. And I could side step the handling and battery problems. The bottom line is that my clients didn't need the bigger files and I didn't need the additional expense. Not in the middle of the great recession...
At the time the medium format digital cameras were ponderous and pricy beasts. They were also slow and mostly used CCD sensors which made them gluttonous battery hogs. But they did have some redeeming attributes such as true 16 bit color capture. I also used one of the Aptus II 80 Meg backs (33 by 54mm) on a Mamiya camera and that convinced me that the smaller sized MF sensors (32 x43 etc.) were mostly a small bit different than 35mm and more of a compromise than a real upgrade.
So, recently two of my photographer friends bought current, entry level medium format cameras. Both bought Fuji GFX 50Rs. One friend, who doesn't shoot for a living, is very happy with his purchase and posts about it frequently. My other friend is a hard core professional who has shot with a previous, larger format Hasselblad MF digital system and he also shot for several years with the Leica S2 MF system. He used the 50R for a couple of weeks and immediately put it up for sale. Why? Because if you are already shooting with a Nikon D850 or an Z7, a Lumix S1R, or Sony's new A7RIV camera (and the best lenses you can lay your hands on) you're probably not going to see much difference between those and the files from the 50R. The lower pixel density might give a different impression of sharpness but there's really not enough difference in the sensor geometry to get you the kinds of wonderful out-of-focus backgrounds we loved film MF for so long ago.
Shoot your 35mm, high res cameras at one stop further open than your smaller MF sensor cameras like the HBlad X1-D or the Fuji GFX'ers and you'll pretty much match the focus fall off between the two formats. If you are buying the very best lenses for your particular system they'll probably be equally sharp at the corresponding f-stops.
I was offered a Fuji 50R camera with the 50mm f3.5 lens, three batteries and some extras for the very sensible price of $3500 but I still can't see the value of that camera over the performance of the Lumix S1R for my work. That, and the fact that we'd be right down the same rabbit hole of buying lots of new and overlapping lenses, batteries, etc. for very little (if any) gain.
Yeah, you might see some differences if you routinely print very large but I'd guess that most of the raves about the pixie MF format images is all about the quality of the lenses more so than it really is about the sensor or the color science being lightyears better than that in the slightly smaller 35mm format.
No, I'm keeping my powder dry when it comes to the MF digitals. I'm holding out for larger sensor sizes (not more resolution, just more real estate). Now... I know it's probably not going to come from Fuji since they are three models and many lenses deep in a commitment to the smaller MF format. Hasselblad is all over the map but their only affordable MF system cameras are also of the pixie sensor variety. You'll still have to cough up good used car budgets for their larger sensor cameras.
I'd much rather spend the extra money (is "extra" money really a thing?) buying supremely good lenses and putting them on very high res 35mm bodies than buy into what I consider to be a compromise format.
But you could look at this from another direction. If you don't do this for a living and you do want to carry a camera around that makes super good images, and you want a different look to your images, and you don't currently own a camera I'd argue that one of the Fuji or Hblad cameras might be a heck of a lot of fun. Just doesn't make sense in this era of lockdowns, diminished engagements and limited opportunities to make commercial images with. Not for me anyway. And I saved $3500 into the bargain.
About half the price of a decent 50mm Leica lens... Oh boy.