Six months of self-hosted Medplum in production — and this month the platform went live across ten clinics in South Florida. I wrote a field report: the conditional-create-as-lock trick for reminders, a no-SDK adapter by design, and an MCP layer where phone, text, website scheduler agents book real FHIR appointments. https://neuryn.substack.com/p/fhir-conditional-creates-and-mcp Happy to answer anything — and grateful to the team, this gave me back months.