Agreed, the challenge is relevant comorbidities/risks rather than all. Another challenge is modelling this well in our notes given the EMR has a propensity to maintain resolved or duplicate past medical conditions.
I co-direct our Y1/Y2 Clinical Skills course at Wake Forest. We teach to include “…significant for…” and ask that it be no more than three RELEVANT diagnoses that could impact the way the HPI is interpreted. @DOCSEducators may have other methods which are used.