you'll find that tilt has the most profound effect increasing from normal to tele and shift has the most profound effect in wide decreasingly to normal.
Given the size of the sensor coverage from 35mm lenses gives plenty of movement (more in fact than my large format lenses on my 4x5 camera. There is even less reason to go to medium format lenses because they are bulky and often not as sharp as 35mm lenses are for the same focal length and cost. This is because when they were designed they were not intended to magnify as much as a 35mm was.
36x24mm capture to 10x8inch print (which btw is a missmatch of aspect ratio always resulting in cropping) is about a x10 magnification while a 6x9 is only about x3 or x4 magnification
here is a blog post of mine from back in 2009
http://cjeastwd.blogspot.com/2009/05/lens-tilt-on-panasonic-g1.html
I was one of the first owners of a micro43 camrea (G1was released in Jan 2009 while the Oly EP1 was released in July, so written before there even was an Olympus m43 camera)
I've written another comparison (for different reasons) here
http://cjeastwd.blogspot.com/2014/01/a-different-slant-on-things.html
looking at what tilt can do for a normal (Sigma 30mm vs Oly OM28mm tilted).
Which is a third reason to not get into medium format, as the focal length needed for wide angles there is something like 60mm while 60mm is quite tele on the smaller format. So unless you want to have an adapter that's used for more or less 1 lens (and its not really handy in super telephoto) there isn't much on the menu when choosing from the medium format restaurant.
Personally I am happy to have one adapter that does tilt and one that does shift, for I use them both differently and I associate each with a focal length group (lumping wides into one group and tele's into another).
Lastly, my primary use of shift has been perspective correction, which I now do mainly with multi shot panos (to get enough data) and software (like PTGui).
For instance this shot is a stitched together HDRI to capture an interior and not blow out the stained glass (and thank god these people just chatted for the whole time)
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PS: long after I wrote that blog post about adapter ideas I bought a ball type tilt adapter (which I was using in the second article) and find that its bloody cumbersome to use.
Now I've owned TS-E 24 and 90mm lenses and the Canon method (like the russian makers copy of that mentioned in there) is the best because it allows you to tilt without throwing the lens center distance off from the sensor plane. Meaning you don't need to refocus just because you apply tilt ... its a bit like the Sinar method in 4x5 studio cameras (which I'm sure Canon were aware of).