So I bit the bullet and got a 5700 XT in a Core X Chroma, replaced the PSU with a Corsair SF600 and the case fan with a Noctua at the lowest speed. Now the setup is barely audible from a graphics perspective, the MBP still spins up when the CPU has some work to do but much better. An expensive workaround but I figure this is probably my last Intel MBP and it'll last until the ARM MBPs are out and enough of the software is updated. And it's fun to have a decent graphics card for my MBP and Windows laptop too. Thanks everyone for sharing your experiences.
FWIW the 5700 XT idles at 29W with two 4K monitors plugged in via HDMI, but it's not affecting the MBP power/thermals of course.
FWIW the 5700 XT idles at 29W with two 4K monitors plugged in via HDMI, but it's not affecting the MBP power/thermals of course.