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For years I thought anything smaller than 6x6 was stupid. Then I started shooting a bunch of 35mm in point and shoots. Realized how fun it was and how photography doesn't always need to be slowed down and super deliberate to get good results. Then I heard about the Fuji GA cameras, basically everything I liked about shooting 35mm point and shoots in a medium format package. Picked one up and have been loving it.
I still think shooting 6x4.5 with an SLR is silly, just as I think shooting 35mm with one is silly. But if you want to shoot MF in a portable package...there are a few good choices out there.