This Ars[1] article does a great job covering what goes into it. I know of more than a few WISP out there in WA state. They can't do the same data rate as fiber but getting a connection is pretty straightforward if there's any large mountains nearby.
[1] https://arstechnica.com/information-technology/2015/11/how-a...
True on knowing how to properly use them! Although to be fair I think most of the ISPs using them don't have a lot of use for really short, high capacity backhauls they're often looking for distance in rural areas.
Edit: Also since you're obviously knowledgeable about this stuff and I don't see a way to contact you on your profile - I've been running a matrix chat room around some of this stuff and would love to have you join! https://riot.im/app/#/room/#startyourownisp:matrix.org