Vail Health ushers in a new structure for breast care with surgeon Dr. Stephanie Miller

In June, Vail Health welcomed its newest breast surgeon, Dr. Stephanie Miller. Miller will work part-time at the practice, splitting her time between Vail and the Denver area.

Miller is a board-certified breast surgeon who has worked in the field for over a decade. Currently, she also works as a breast surgeon in the Denver area, primarily at HealthONE, and serves as the medical director of two of the Denver area’s major breast programs.

A new structure for the breast care program

Miller is stepping into the role following some changes with Vail Health’s breast care center, which falls under Vail Health Clinics.

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Earlier this year, Vail Health announced that Dr. Julie Barone, who served as a breast oncoplastic surgeon and the medical director of the breast care program at Shaw Cancer Center since March 2020, would be leaving the program. The breast program was formed in 2020 with Barone as the first specialized breast surgeon for the health care system.

Barone’s last day at the hospital was May 2. She is now serving as the medical director of the breast program at Mission Hope Cancer Center in Santa Maria, California.

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Rather than fill the position with a single surgeon, Vail Health decided to bring in multiple part-time breast surgeons to fill the area need. In February, at the health care system’s annual address, Vail Health CEO Will Cook said that the patient volume was not at a level that made sense to keep a breast surgeon full-time and that having a new model would be more feasible.

“Vail Health is committed to having a successful and sustainable breast surgery program. Having two part-time breast surgeons provides expanded coverage to ensure scheduling availability as well as additional experience, knowledge and insights to an already superb breast care team,” David Kaplan, president of Colorado Mountain Medical said this week. “This new structure allows for expanded care across multiple locations in a more sustainable way and will also help prevent provider burnout.”

Kaplan added that this structure will enable “greater capacity and cross-coverage for this specialty in the long-term.”

With Miller stepping into the first part-time position, the hospital is still working to bring in a second part-time provider as well as working out exactly what their schedules will look like.

However, the expectation is that the two breast surgeons will “participate together in our weekly tumor board meetings and discuss ways to ensure collaboration across patients for clinical care and even administrative duties,” Kaplan said.

“This model is more of the standard than an outlier as every urban clinical service line works in this manner,” Kaplan added.

In the future, Vail Health is also planning to recruit and hire a full-time advanced practice provider that will be managed by both breast surgeons, Kaplan said.

Currently, the future of the breast program also includes a potential expansion in Dillon. Sally Welsh, Vail Health’s director of public relations, said there was been interest in growing the breast program at Vail Health’s Dillon Health Center, but that it will come down to what’s needed in that community and understanding what the volume would be.

In stepping into this new role, Miller said that while she is excited about the opportunity, she was also sad she wouldn’t have the opportunity to work with Barone directly. “We’ve worked near each other for the last, almost 20 years, but never quite at the same place,” she said. “So, that was my only sad thing is that we weren’t going to actually be able to work together.”

Looking ahead, Miller added that “the community can feel very confident that what is currently available is going to continue to be available to them.”

Still, she said that she and Vail Health see this transition as an opportunity to grow and develop the program “to meet the community’s needs as best as possible,” Miller said.

Becoming a breast surgeon

Miller has been in Colorado since 1995 when she moved to Denver to do her surgical training at the University of Colorado.

“I came to the university to get my surgical residency, and I had this blind belief that if I could ski, then I could get through anything — and surgical residency has a reputation for being quite arduous. I was definitely too tired to drive up to go skiing during many of those years,” Miller said.

However, as she’s stayed in Colorado and raised her family here, she’s since been able to take advantage of the mountains and all the activities that come with that. Miller listed skiing (including backcountry skiing), hiking, running, rock climbing, mountaineering and alpinism among some of her favorite activities today.

In 1995, Miller began her training in general surgery, “because when I did my training, that’s what you did … there wasn’t a fellowship in breast,” she said.

However, as she began working, she intentionally sought out a program where she would be doing a lot of breast surgeries and spent a lot of her time focusing on that.

“I always knew that I would be doing quite a bit of breast surgery as a woman in this field. And back when I did my training, there were far fewer women in this field,” Miller said.

Eventually, she was able to transition her practice to specialize in this field of work and has now been doing it for over a decade.

“I can’t imagine what it would be like in a different line of work. So I’m just really fortunate from that standpoint,” Miller said. “I have the privilege of getting to know people in a very intimate way. You really do feel like you’re contributing in a positive way at a very difficult time, which is really a remarkable thing about what we do, and we’re really lucky to be able to do it.”

Part of her own professional evolution included getting an MBA in 2017.

“We don’t like to think about medicine as a business, and we certainly aren’t trained that way to think about it,” Miller said.

However, having an MBA has “allowed me to use some of that business thinking and strategic thinking,” and translate that into providing better programs and ultimately, better care, she added.

At the heart of this is understanding “how do we create breast programs that can accomplish what we do; utilizing the resources in a responsible way, both financially for patients, but also for the entities that are helping supply them to us, which is all the different hospital systems,” Miller said.

“We need to work together to be able to create good programs so that we have everything we want to offer to patients,” she added.

In addition to her dedication to the field of breast disease, Miller has a passion for improving health care sustainability. That is, changing how health care looks at their environmental impacts from waste use and diversion, energy utilization and management, and more.

“The impact on climate change from our healthcare system is not negligible,” Miller said, adding that for her personally, it’s about “how do I use my position in this system, not just at Vail, but in the medical system, to have a bigger, broader impact that can be beneficial for us as a society as a whole?”

As Miller has continued to specialize she’s seen the industry and field of breast care evolve as well. This includes watching the field move to prioritize personalized care, whether through technological advancements in radiation and chemotherapy, improvements in cosmetic outcomes and taking a whole-person approach to women’s health.

This concept of personalized care boils down to “finding ways to treat a person’s individualized cancer rather than using sort of a ‘large hammer,’ using something that’s much more refined so that we get better results,” Miller said. “In that, we see that we have much better outcomes.”

Bringing her expertise to Vail Health

Ultimately, it was a combination of Miller’s love for the mountains and her kids being at the right age — one having graduated law school, another who graduated from West Point and is serving in the military and the third who is a senior in business school — that allowed her to take the new position at Vail Health.

“I love being in the mountains. It is a different culture. It is a different experience. It’s always amazing how invigorating it is for the mind and the soul to be in the mountains,” she said. “Now, I’m not as tied to where I am now, so it gave me more flexibility.”

Taking the new position is the perfect opportunity to combine her professional passion and connect to the mountain communities she loves, she noted.

“It opened me up being connected to that community and being able to serve that community in a way that I hadn’t been able to before,” Miller said.

Since starting in early June, Miller has been “nothing but impressed” by the program at Shaw and Vail Health.

“It’s like if I could have imagined a program, Vail and the Shaw program has so many components of that already,” Miller said. “It’s really collaborative, and the community is very collaborative, and it really is patient-centric in what they’re trying to do.”

Plus, “the team there is already really well established,” she added.

Looking ahead, Miller is ready for the opportunity to contribute to this program as well as find ways to keep making it better.

“There’s so many opportunities and that’s really exciting because you really feel that you can help make your mark on the future,” she said.

“There’s always the responsibility of how you continue what’s there so that it reaches out to the patients or to the people in the community so that they have the awareness and the ability to take advantage of the wonderful program that just sits in their backyard already,” Miller added. “Everyone’s worried when there’s change, but the program is far bigger than any one piece of change.”