In a follow-up interview with Catholic News Service, Patino stood by his strong statements, which made national news and cast him as an unlikely anti-crime crusader.
"If you're an ordinary citizen and someone commits a crime against you, who do you complain to?" the bishop asked.
Fr. Gregorio Lopez, vicar of the Apatzingan cathedral, said Patino is "denouncing with names, something no one did before."
"The bishop is prudent, but he's also brave. He's a combination of the two things," he said.
Mexican bishops have seldom made such strong statements on security, even as a government crackdown on drug cartels and organized crimes claimed an estimated 70,000 lives over the past seven years.
The bishops' 2010 pastoral letter made little media impact, and the Church has had to explain allegations that cartel kingpins made donations, constructed chapels and consider themselves Catholics, despite dealing drugs and kidnapping and killing innocent people.
But with Pope Francis blasting drug cartels and organized crime — most forcefully during his July trip to Brazil — opportunities may be opening for Mexican bishops to make more critical comments.
"We've continually been speaking out ... but now, much more forcefully," Patino said.
Even Michoacan Gov. Fausto Vallejo, who downplayed an Oct. 27 wave of attacks on 18 electrical substations as vandalism, said of the bishop: "He's right in much of what he says. We have no reason to hide our reality."
Media have moved in on a region the bishop says had been overlooked and, in many cases, covered by reporters either cowed or corrupted by criminals or influenced by protesters — paid off by the cartels, he alleges — who demand the police and army leave Michoacan.
Reporters covered an Oct. 31 pilgrimage for peace and recitation of the rosary, when Patino revealed that criminals had killed five of his priests over the past 17 years.
"This is the kind of thing that no good man can stay silent on," Patino said.
Priests say they've been increasingly under threat for their support of self-defense groups, which the government alleges are infiltrated by drug cartels. Priests deny that charge. They have shown support for the self-defense groups through simple gestures, such as allowing them to ring church bells to signal gatherings or warn of emergencies.
The priests exchange information regularly and say they have petitioned their bishop to condemn the corruption, drug dealing and crimes like extortion and kidnap that affect ordinary people.
"Our voice isn't heard sometimes, but his voice has weight," said Fr. Andres Larios, parish priest in the municipality of Coalcoman. "The letter was edited by many priests, but he signed it."
Patino's letter received shows of solidarity from the Mexican bishops' conference and the archdioceses of Mexico City and Acapulco, but whether the bishop's behaviour signals a sea change is uncertain.
Auxiliary Bishop Eugenio Lira Rugarcia of Puebla, bishops' conference secretary-general, said he sees no change in posture, noting that the bishops have been issuing letters on violence in Mexico since 2000.
Bishop Javier Navarro Rodriguez of Zamora, also in Michoacan, told reporters Nov. 11 that all of the state's bishops delivered a letter on security to interim Gov. Jesus Reyna in May.
"Our fear remains because, once (the federal police) withdraw, all of the (bad guys) would come out of hiding to continue their work. Our communities feel defenseless," said Navarro, vice president of the Mexican bishops' conference.
Michoacan unfolds to the west of Mexico City and been at the centre of Mexico's crackdown on crime and drug cartels. Drug dealing there dates back decades, but Patino said it was more a mom-and-pop operation than big business.
"They used to have small guns ... small cars. Now they have bulletproof vehicles," he said.
A cartel known as La Familia Michoacana surged in late 2006, taking control of crime in the state and building a social base. La Familia subsequently splintered, with a sect known as Knights Templar emerging as the victors. The cartel teaches a homemade religion, complete with its own version of the Bible, authored by La Familia founder Nazario Moreno Gonzalez, better known as "the craziest one."
Moreno was killed in 2010, but shrines have appeared across the region with his image, and people venerate him as "St. Nazario."
"They've created their own sect," Patino said. "They've put small chapels in all the hamlets. They inaugurated them with drunken parties."
Patino's letter said the regional conflict was driven, in part, by cartels trying to reclaim the municipalities and crime territories lost to self-defense groups by preventing the delivery of basic supplies such as food and gasoline.
"In these municipalities, members of organized crime were expelled, which ended the (illegal) payments, extortions, abductions, kidnappings and rapes," Patino wrote.
Larios was among the priests helping the self-defense groups. He fled the diocese for a month earlier in the year after being threatened by criminals for his support of a self-defense group in the town of La Ruana and denouncing the extortion attempts on lemon growers and packers. Those actions threw desperately poor pickers out of work, he said.
Criminals told him, "You shouldn't be with them, Padre," Larios recalled.
By ringing the church bell, they said, "You're with them and they're our enemies."
Larios said priests have been harassed and threatened since Patino published his open letter. Lopez said the bishop was threatened by armed men appearing at the cathedral.
Patino appeared unfazed and promised to continue ministering to all parts of his diocese, despite the dangers.
"It's worth the effort to people coming to the church at this difficult time," he said.