Here's what I do with no macros whatsoever (helps for multiple reasons). I really really like it. What I trade in flexibility I get back in dependability and not having to think about it. I have tweaked both of my sets over time and have other buttons for special situations (4xFire Nova key, for example). This is an older set, but I think you get the idea...


PvP
Button U: 1-Tremor, 2-Grounding, 3-Earthbind, 4-Searing
Button I: 1-Grounding, 2-Tremor, 3-Grounding, 4-Poison
Button O: 1-Poison, 2-Searing, 3-Healing, 4-Tremor
Button P: 1-Searing, 2-Healing, 3-Healing, 4-Grounding

PvE
Button J: 1-Mana Stream, 2-Healing, 3-Healing, 4-Healing
Button K: 1-Wrath of Air, 2-Totem of Wrath, 3-Totem of Wrath, 4-Totem of Wrath
Button L: 1-Totem of Wrath, 2-Grounding, 3-Grounding, 4-Grounding
Button ;: 1-Tremor, 2-Stoneclaw, 3-Earthbind, 4-Stoneclaw