Adobe Lightroom uses an automatic placement when removing spots in an image. The placement of the sampled area in the image can be adjusted, but for images with a large amount of work, this is very tedious and inefficient. This idea would make spot removal as easy as it is in Photoshop.
This wish would be to have an Alt-key override in the spot removal. We could keep the default behaviour just as it is today. However, if a user were to hold the Alt key down, they could use the first click as a sample location and the second click as the spot to apply the healing. This is the same behaviour in Photoshop and has been proven as a best practice.
I would like to also see behaviour that remembers the offset from the last Alt key press and uses that offset for subsequent healing. However, that may be too much programming for an override process.
In any case, this would be an extremely efficient use and would keep me from feeling the need to export work to Photoshop for spot removal.