You do not have to use eqw, although it's the easiest way.
You can also make a shortcut to eqgame.exe, edit the shortcut and in the Target field, after eqgame.exe, add a space and the word patchme.
If the path to your EQ dir has spaces in it, then the path in the Target field will have quotes around it. Place the above patchme change AFTER the closing quote, not within.
So depending on where you have EQ install, you should have something like:
"C:\Program Files\EQ\eqgame.exe" patchme
or
C:\EQ\eqgame.exe patchme
Hope that helps...