>>>In a past life I ran email services for a small business, and then a medium business it was a full time job, just keeping us out of the spam blacklists
Running it onPrem using the ISP the is connected to office I bet... That is a common problem with small businesses as they do not properly setup the ISP service and many SPAM lists automatically add the dynamically assigned IP ranges of most ISP has these are not setup to allow hosted services across them so by default no one expect to see a email server on that type of connection. Thus it is blocked.
Outside of that companies like MailRoute can help with routing to email traffic, and provide some level of HA for your email services.
>> ecosystem changes (e.g. new DNS records every few years, new security requirements, etc)
SPF, DKIM, DMARC are not really new, nor have they changed much in years. Thought most people still fail at getting it right. I am dealing with an issue with my bank right now where one Division is not talking to another division but they all use the same main domain for sending email so of course SPF record does not have ALL of the mail servers listed ... sigh...
>>filtering incoming spam/malware/philishing attempts.
There are many 3rd parties out there providing these types of services, I would use them. MX Gaurd Dog is probably one of more reasonably priced services but there are all kinds of other from Mimecast to Proofpoint, and many many others
>>I tell them outsource email to a major provider and use your limited time/effort elsewhere. Better rate of return by far.
I am not opposed to that persay. I also advice my clients if they are going to do that, at minimum they need a email archiving solution that is NOT with that same provider so they do not have all of their critical communications locked up in a single point of failure. For better or worse many companies live and die by email and if Email data is lost that can be DEVASTATING to a company. Having it all locked into a service you do not control is a high risk business ending decision IMO