A colleague of mine at Microsoft, Jeff Jones, has written a thought provoking couple of articles on security patches/bulletins/errata and 'customer pain'. He does this primarily to help improve the security update experience for Microsoft customers, by analyzing issues and providing guidance on remedies to make the life a little easier for folks.

Have an open mind when you read these!

Security in Operation (Part 1 of 4): Windows, Linux and Security Notifications
http://www.microsoft.com/technet/community/columns/secmgmt/sm0305.mspx

Security in Operation (Part 2 of 4): When an Issue Affects Multiple Products
http://www.microsoft.com/technet/community/columns/secmgmt/sm0405_2.mspx