Your personal economic and political views may also impact your decision. Some people are very concerned that the tax brackets themselves will be much higher in retirement, so they prefer to pay taxes now and use Roth accounts. Others are worried the government will change the law in order to tax money contributed to Roth accounts twice. These folks take the “bird in the hand” approach by using a tax-deferred account. Frankly, I think planning is done best using current law as your guide since predicting future Congressional acts seems to require a crystal ball.

There are also other, more minor, considerations. For example, if you plan to move from a state with a state income tax to a tax-free state in retirement, you should favor tax deferment. Although most physician families won’t qualify for much significant college financial aid (aside from loans), using Roth accounts can lower the expected family contribution on the Free Application for Federal Student Aid. There are also estate-planning considerations. Estate tax is levied against the total amount of the account. Therefore, if you expect to have an estate tax problem, it might be best to favor Roth accounts since you have more after-tax money available for the same-size account. Heirs also prefer to inherit a tax-free Roth IRA over a traditional IRA. It is also possible that the total tax due could be reduced by leaving the traditional IRA to an heir in a lower tax bracket.

Confused yet? With good reason, you might be—it’s a complex decision. Roth 401(k) contributions are a great option to have, but the decision about whether to make Roth or traditional contributions is a complex one that depends on many personal and nonpersonal factors that may change in the future. Following these guidelines can help you optimize your retirement savings and tax situation.