Eh, I'd argue this varies a lot. In some cases you are more likely to run into issues setting up multiple SIP clients behind a NAT trying to connect to a server out on the public internet than you are to install your own PBX on-premises.
Grandstream, Yealink, etc. all provide pretty easy to administer Asterisk-based PBX appliances that can be paired with a SIP trunk of your choice (shout out to Flowroute here, they're great).
If you're feeling more adventurous sipXecs from sipfoundry is pretty easy to configure relative to the additional complexity it brings over the more simplified alternatives. I went from having 0 real world experience with SIP to managing a small installation for my aunts shop as well as one at home in a couple days.
For proprietary offerings there's of course Skype for Business, etc. and I would argue they aren't terribly hard to configure or maintain either.
Most of the work is just in network configuration once you have multiple sites and you need to ensure QOS going over your MPLS or whatever to ensure your voice packets take priority - that can be more difficult but that's something a competent network admin can help you with.