Hey EncorePete,
Sorry I didn't realize you were a doctor. My doctor advised me to get rid of my muzzlebreaks ( he hunts & shoots ) and a close friend of mine who has shot breaks for years now has a hearing aid in both ears. At one point every guy I hunted with used them and now we have all sold them off. Not sure how old or how much hunting you do but hey you have the right to destroy your hearing and not listen to other experienced hunters mistakes. I hope you hunt alone as those things also damage whoever is standing next to you also.