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The strong suit of vehicles like this is in their reliability. Not about FE, per se, just that it be predictable. While FORDs and the 7.3 are a decent combination you are looking at a vehicle at the end of it's "predictable" life. End of engine life, sooner than later.
For someone running scheduled service (clients to appointments) I guess they'd better be poor, patient, or both. With whatever arrangements folks have to make with yet other people in order to be ready for transport, unreliable service makes for headaches that ripple outwards. It is more than just a missed appointment.
Without some mechanical skills and the desire to always acquire more, running a vehicle like this can become expensive quickly due to reliance on paid work. And a headache to those relying on it (clients, not those who profit from them). For the owner it would be good to have a backup plan in place beforehand, and to understand the costs in all ways.
Be sure to understand insurance requirements. And licensing. Add to that air conditioning. Never put clients in a position for heat-related problems.
Sorry for the downer. Nail all the bad stuff first, because the per patient cost is higher than it will first appear. Liability is the nightmare.
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