In some cases the Patch tool is much more useful/effective than the Spot Healing tool or Healing Brush. Sometimes you can remove long scratches from a scanned image in one action (only making a proper selection takes some time).
Agreeing with David:
The ACR/LR Retouch tool is also handy, but you need to watch for colour differences -- watch the difference between Heal and Clone. You can only use this by placing spots, not as a brush. Using Heal smoothes colour differences out more, but can't be used to Clone out dark bigger or light spots, because it looks at surrounding pixels for it's brightness.
Retouch is nice because it's a one time job. When you want to develop a RAW file differently, you won't have to do the retouching over again in PS! In that sense, it's good to do this step in the pre-processing part of your workflow. I've never seen sharpening affecting my retouching negatively.