For the Red Sox, it is arguably less significant what they decide to do with left-hander Andrew Miller than the mere fact that they have a challenging decision to make. That development – which was reinforced by a pair of performances some 1,200 miles apart on Tuesday – represents a significant consideration as the Sox try to steel themselves for the inevitable toll a summer takes on their pitchers.

The Sox reside in a division that features ruthless offenses. Though Boston leads the majors in runs scored, the Yankees and Blue Jays rank second and third in the AL in that category; the Rays and Orioles are in the middle of the pack, but still feature enough tough outs that they can do some damage to lesser pitching.

That being the case, one of the central challenges of winning in the AL East remains unchanged. A team needs to keep its best starters healthy, and when it does inevitably encounter injuries among its arms, it needs to have extremely solid depth options to turn to. Otherwise, the consequences of a pair of ill-timed injuries to members of the rotation can be devastating.

“The best way to get your season derailed is to not have enough pitching,” manager Terry Francona said in May, repeating a statement that he has made on numerous occasions throughout his Boston tenure.

The Red Sox starting rotation has already encountered a fundamental change this season. With Daisuke Matsuzaka having undergone Tommy John surgery that will have him out until at least late-2012, the Sox have turned to Tim Wakefield as their fifth starter.

Thus far, the returns on Wakefield have been extremely positive, a trend that continued in the Sox’ 4-0 loss to the Rays in Tampa Bay on Tuesday night. (Recap.) Wakefield gave up two runs (one earned) on just four hits over seven innings of work. Though he had to work around five walks, that command issue was a reflection of the fact that his pitch danced through the batter’s box in a way that confounded Rays hitters for most of the night.

“He was tremendous,” Francona told reporters of Wakefield’s outing.

Wakefield now has a 4.29 ERA in seven starts this year with three quality starts. Opponents are hitting .236 against him, a lower mark than batters have this year against either Jon Lester (.242) or Clay Buchholz (.248).

The team’s record when he takes the mound is 4-3, suggesting that – as has been the case for the better part of two decades – Wakefield is giving his team a chance to compete when he takes the ball.

Yet as the minor league season has unfolded, the Sox’ options – even with Matsuzaka’s injury – appear to be increasing. That notion has been brought into sharp relief by the performance in Triple-A of left-hander Miller, who continued one of his best professional runs while pitching in Pawtucket on Tuesday night.

Miller logged 5 1/3 innings for the PawSox while punching out a season-high 10 and walking just one. He continues to reap the fruits of an altered pregame routine that coincided with the start of his run, in which he simulates the first inning of a game before his start.

The results since he started implementing that approach have been tremendous. A pitcher whose command had reached a point of crisis last year (7.2 walks per nine innings in the majors, 6.8 walks per nine in the minors) has been throwing strikes as never before.

In his last four starts, Miller has a 1.78 ERA with 26 strikeouts and three walks in 25 1/3 innings. Asked about the diminished free passes, Miller acknowledged that he could not recall another time in his career when he had enjoyed such a sustained run of limiting his walks.

Now, he and the Red Sox are set to meet on Wednesday to decide how to proceed. Miller has a June 15 opt-out of his minor league contract (which calls for him to earn a prorated portion of a $1.2 million salary if/when he is called up) if he is not summoned to the majors. If the Sox do not add Miller to the big league roster and he exercises the clause, he will become a free agent.

The Sox clearly do not want to see the talented left-hander depart. On different occasions, Francona has suggested that his stuff – a mid- to high-90s fastball and wipeout slider coming from the arm of a 6-foot-7 left-hander – is reminiscent of both future Hall of Famer Randy Johnson and of a left-handed version of Sox setup man Daniel Bard.

And so, the discussion between the Sox and Miller is likely to be about what form their relationship will take going forward, rather than whether or not he will exercise his opt-out (his first of two, it is worth noting – the Boston Herald reported on Tuesday that Miller has a second opt-out on Aug. 5).

According to a team source, “everything is open” regarding Miller’s future in the organization, a phrase that encompasses both the timing of his promotion to the majors as well as the pitcher’s role.

The Sox could promote him and insert him into the rotation to see whether Miller can achieve big league results that match his well-above-average major league stuff. That, however, would necessitate a rotation shuffle.

The path of least resistance might be to promote Miller and insert him into the Sox bullpen. While that solution would be somewhat imperfect given that the left-hander hasn’t been able to define a bullpen routine this year, he does have 25 games of relief experience as a big leaguer.

He could agree to remain in the minors while working out of the rotation, thereby serving as a depth option while remaining on the routine that has begun to pay such notable dividends for the former No. 6 overall pick in the 2006 draft. He could spend some time in the minors working out of the bullpen to prepare him for the possibility of a relief role in the big leagues.

Miller, after his start in Pawtucket on Tuesday, told reporters that he would be more than happy in either the Red Sox rotation or bullpen.

“I’m property of the Boston Red Sox. If they call me up, they can do whatever they want with me. I’ll happily do it, and I’ll give it everything I’ve got. I’ll start, I’ll relieve, I’ll play second base. It doesn’t matter,” he told reporters. “If there’s a spot in the big leagues, I want it. That’s what we all, that’s where everyone in this locker room wants to be. That’s what we’re working for I guess.”

The 26-year-old said that he would discuss his options with his agent, Mark Rodgers, on Tuesday night in advance of his conversation with the Sox. While he is eager for the opportunity to return to the majors, Miller also made clear that he wants to values the progress that he has made in the Sox organization, and that he’d like to remain with the franchise.

The pitcher understands that he is moving in a positive direction for the first time in quite some time. At the same time, he appears to recognize that four strong starts do not define an end-point to his progress. Instead, he hopes to continue to make strides as a member of the Sox.

“The Red Sox in general in every aspect have given me every opportunity. They’ve been first class. I don’t have any complaints at all. Certainly, it’s a good place, good fit for me,” Miller told reporters. “Things are certainly going the right direction here. It would certainly be a shame not to keep it going. …

“Considering the year I had last year, the ups and downs I’ve had the last probably year and a half, for me, it’s been nice to go out and show that it’s still there and I’m showing here that I think I can be a good major league pitcher,” he added. “At this point, when I came in and signed with Boston, I knew that it was kind of a long-term project. I wasn’t going to short-sight anything. I think I’ve come back and I’ve started to establish that I’m on the way back. I’m looking to go to the major leagues and stay up for a long time. It doesn’t matter when it starts. It’s more the long term.”

Of course, while Miller and the Sox are indeed considering what is in the pitcher’s long-term best interests, there is also a shorter-term reality that his emergence presents to the club. At a time of year when some clubs are taking their prospect inventory to figure out what they might have to give up in the middle of summer to reinforce their rotation, Miller represents a potentially deep group of viable rotation options for the Sox as pitchers wilt in the summer.

Wakefield and Alfredo Aceves have already both shown an ability to stabilize the rotation in the face of injuries. During the two-and-a-half weeks when both Matsuzaka and John Lackey were on the DL, the Sox went 10-6 in part because their rotation was not wrecked by their replacement starters.

Now, Miller looms as a potential contributor as well. So, too, does Felix Doubront, who has been getting swings and misses with his fastball, curve and changeup en route to a 2.33 ERA, 30 strikeouts and nine walks in 27 innings with Pawtucket this year. While his health has been an issue this year – first with an elbow issue in spring training, then with a sore groin that cost him half of May – the left-hander has been perhaps even more impressive than he was in earning his summons to the majors last year.

“He’s been great. We’re very, very happy with how he’s thrown all year,” said Sox VP of Player Personnel Mike Hazen. “The stuff has been really good. This guy’s a pretty good pitcher.”

And the cutter that has allowed Kyle Weiland to forge a 3.29 ERA while striking out more than a batter an inning for Pawtucket has also made him an intriguing depth possibility. The pitcher who had been viewed as a likely contributor out of the bullpen at the major league level is instead giving indications that, somewhat like ex-Sox prospect Justin Masterson, he may earn a shot at some big league starts.

The Sox are mindful of the notion that a team needs at least eight or nine starters in order to withstand a full 162-game schedule. In a relentless division, any shortcoming quickly can become a fatal weakness. That being the case, in the absence of viable fill-ins, an injury or two can force a team to make trades out of desperation, which typically result in steep costs.

While the situation could certainly change, for now, the Sox are not in that boat. On the contrary, they are evaluating how and when to offer big league opportunities to pitchers who have earned them, at a time when they have reason to be pleased with the shape of their current big league rotation.

And so, if Miller’s situation represents a predicament for the club, it is a welcome one.