Is LR's noise reduction poor or am I doing something wrong?
As far as I have used it, and according to my taste, it is very good since v1.1 if you stay on a rather conservative side.
With my 300d, I typically set luminance NR between 0 and 15, and chroma NR between 10 and 50 : I do end up with noise, but it's a monochromatic and not-so-ugly one, that blends rather elegantly with original textures.
I didn't manage to achieve the very smooth look of NeatImage, but it may also be because I don't like this "plastic-like" look that much . In my taste, these powerful NR plugins are at their best with scans or other very grainy images.