I’ve spent nearly 2/3 of my career dealing with Microsoft patches at one level or another, so when it comes to excuses, I think I’ve probably heard them all.
This diary entry from the Internet Storm Center has good answers to the most common objections. I think a two-day patch cycle may be overly aggressive, and I know it drives infrastructure folks nuts when CISOs read stuff like this and then say, “Patch my stuff in two days like this guy,” but most organizations can take his advice, and even if they slow it down to 30 days instead of two, they’ll still be in a better place than they are today.

David Farquhar is a computer security professional, entrepreneur, and author. He has written professionally about computers since 1991, so he was writing about retro computers when they were still new. He has been working in IT professionally since 1994 and has specialized in vulnerability management since 2013. He holds Security+ and CISSP certifications. Today he blogs five times a week, mostly about retro computers and retro gaming covering the time period from 1975 to 2000.
